Abstract
Background : Nurse practitioners (NPs) are a growing workforce with significant potential to improve access to primary care services across the life course and across diseases and conditions. However, in interprofessional primary care settings, some nurses experience practice limitations, reducing their contribution to the response to primary care population needs.
Approach : In 2022, the province of Quebec, Canada, opened its first “NP-clinics” to improve access to primary care and reduce pressure on emergency departments. The services offered by these clinics is predominantly provided by NPs with a holistic approach. The services are designed to ensure access to the right services, at the right time in the right place. They must also go beyond the provision of acute care and focus on integrated care and care continuity between care settings.
The objective of this study is to examine the effects of 8 participating NP-clinics on the patients’ use of primary care and emergency department services.
Over a 3-year period (2 years before and 1 year after the openings of the participating clinics), we collected medical-administrative data from all the patients who consulted at least one time in ont of the participating NP-clinics. A control group was matched using propensity scores on gender, age group, comorbidity index, level of rurality and level of deprivation.
Results : The results of this effects analysis using 3 indicators of access to primary care services will be presented. The measured indicators include the use of primary care services, the use of the emergency department, and the hospitalizations for ambulatory care sensitive conditions.
Implication : Our results will allow us to evaluate the effects of NP-clinics on the improvement of the access to primary care services for all the patients. These clinics have evolved since their opening, our longitudinal results will allow us to examine whether these effects change over time.