5. Results : Taxonomy PHC Models Industrialized countries

6. Industrialized countries: 4 PHC Models Limited range of services : Medical, from preventive to curative Wide range of services: from promotion to palliative, medical to community, screening to home care Pract. MDs : individual/group Governance : professionals Healthcare centres Governance : Pop. representatives MDs paid : time based Organ. Team : MDs & Nurses Funding : MDs compensation Multidisciplinary team Funding : lump sum from RHA RHA oversee services & resource allocation to PHC & other levels of healthcare Res Provision of services Medical services Clients or enrolees Population health & development Health needs Comprehensive services Vision Professional Models Community Models Comp

7. Industrialized countries: 4 PHC Models No 24/7 No longitudinal continuity Independent provision of services Provision in conjunction with others (contract/purchase) - 24/7, comprehensiveness Longitudinal continuity Pract. No formal integration mechanism Networking with other PHC facilities Organ No IT Availability of IT Transfer clinical & admin. info To facilities serving the population Res. Vision Non-integrated Community-based Integrated Community model

8. Industrialized countries: 4 PHC Models No formal integration mechanism Longitudinal continuity Clinical integration : nurses liase with system components Pract. Organ MDs Availability of IT Transfer info within own unit MDs paid : more on FFS, capitation or mix MDs & nurses Availability of IT Transfer info: whole system MDs paid : capitation or mix Res. Provide accessible services To clients Provide continuous & coordinated services To enrolees Vision Professional Contact Model Professional Coordination Model Comp

9. Quebec : 6 PHC Models 6 PHC MODELS Community model Professional PHC models Contact Models Coordination models Solo Closed Group Closed Group Open Integrated PHC Integrated System Integrated model

10. 6 PHC Organisation Models

11. 6 PHC Organisation models

14. Ranking of PHC models on effects: 38 studies in industrialised countries 1 2 3 3 Quality 3 3 1 1 Responsiveness 1 2 3 3 Equity 3 4 1 1 Accessibility 1 2 4 3 Continuity 2 3 1 4 - Use 1 1 3 3 - Cost Productivity 1 2 3 4 Effectiveness Integrated community model Non-integrated community model Prof. Coord. model Prof. contact model Models Effects

15. PHC organisation Models & Effects