title: Constructing taxonomies to identify distinctive forms of primary healthcare organizations.
abstract: Background. Primary healthcare (PHC) renewal gives rise to important challenges for policy makers, managers, and researchers in most countries. Evaluating new emerging forms of organizations is therefore of prime importance in assessing the impact of these policies. This paper presents a set of methods related to the configurational approach and an organizational taxonomy derived from our analysis. Methods. In 2005, we carried out a study on PHC in two health and social services regions of Quebec that included urban, suburban, and rural areas. An organizational survey was conducted in 473 PHC practices. We used multidimensional nonparametric statistical methods, namely, multiple correspondence and principal component analyses, and an ascending hierarchical classification method to construct a taxonomy of organizations. Results. PHC organizations were classified into five distinct models: four professional and one community. Study findings indicate that the professional integrated coordination and the community model have great potential for organizational development since they are closest to the ideal type promoted by current reforms. Conclusion. Results showed that the configurational approach is useful to assess complex phenomena such as the organization of PHC. The analysis highlights the most promising organizational models. Our study enhances our understanding of organizational change in health services organizations.
authors: Direction de santé publique de l'agence de la santé et des services sociaux de Montréal, 1301 Sherbrooke Est, Montréal, QC, Canada H2L 1M3 ; Institut national de santé publique du Québec, QC, Canada ; Département d'administration de la santé et institut de recherche en santé publique de l'université de Montréal, QC, Canada.
authors: Roxane
authors: R
authors: Borgès Da Silva
authors: Direction de santé publique de l'agence de la santé et des services sociaux de Montréal, 1301 Sherbrooke Est, Montréal, QC, Canada H2L 1M3 ; Institut national de santé publique du Québec, QC, Canada ; Centre de recherche du centre hospitalier de l'université de Montréal, Montréal, QC, Canada.
authors: Raynald
authors: R
authors: Pineault
authors: Direction de santé publique de l'agence de la santé et des services sociaux de Montréal, 1301 Sherbrooke Est, Montréal, QC, Canada H2L 1M3 ; Institut national de santé publique du Québec, QC, Canada.
authors: Marjolaine
authors: M
authors: Hamel
authors: Institut national de santé publique du Québec, QC, Canada ; Centre de recherche du centre hospitalier de l'université de Montréal, Montréal, QC, Canada ; Département de médecine familiale, université de Montréal, Montréal, QC, Canada.
authors: Jean-Frédéric
authors: JF
authors: Levesque
authors: Centre de recherche de l'hôpital Charles Lemoyne, Longueuil, QC, Canada ; Université de Sherbrooke, Sherbrooke, QC, Canada.
authors: Danièle
authors: D
authors: Roberge
authors: Département d'administration de la santé et institut de recherche en santé publique de l'université de Montréal, QC, Canada.
authors: Paul
authors: P
authors: Lamarche