Do nurse practitioners-lead clinics increase primary care access? A longitudinal study in Québec, Canada

Arnaud Duhoux, Nadia Sourial, Émilie Dufour, Marie Eve Poitras, Annie Rioux-Dubois, Arianne Fauteux-Duarte, Nancy Cote, Morgane Gabet, Marlène Karam

Keywords: Primary care; Access ; NP; NP-lead clinic

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. 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 and include telehealth. They must also go beyond the provision of acute care and focus on integrated care and care continuity between care settings.

Research questions:

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.

Method:

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 one of the participating NP-clinics. A control group was matched on gender, age, comorbidity, level of rurality and deprivation.

Results:

Overall, NP-Clinics were able to manage 95% of the consultations. The results of the analysis of effects 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.

Conclusions:

Our results will allow us to evaluate the effects of NP-clinics on the improvement of the access to primary care services. These clinics have evolved since their opening, our longitudinal results will allow us to examine whether these effects change over time. The results may help other countries developing the advanced nursing role in primary care to identify its potential benefits.

Points for discussion:

Contribution of NPs to meet the primary care needs of the population

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