title: Quality assessment of primary care for common mental disorders in isolated communities: Taking advantage of health records.
abstract: BACKGROUND
  This article is part of a research study on the organization of primary health care (PHC) for mental health in two of Quebec's remote regions. It introduces a methodological approach based on information found in health records, for assessing the quality of PHC offered to people suffering from depression or anxiety disorders.
  
  
  METHODS
  Quality indicators were identified from evidence and case studies were reconstructed using data collected in health records over a 2-year observation period. Data collection was developed using a three-step iterative process: (1) feasibility analysis, (2) development of a data collection tool, and (3) application of the data collection method. The adaptation of quality-of-care indicators to remote regions was appraised according to their relevance, measurability and construct validity in this context.
  
  
  RESULTS
  As a result of this process, 18 quality indicators were shown to be relevant, measurable and valid for establishing a critical quality appraisal of four recommended dimensions of PHC clinical processes: recognition, assessment, treatment and follow-up.
  
  
  CONCLUSIONS
  There is not only an interest in the use of health records to assess the quality of PHC for mental health in remote regions but also a scientific value for the rigorous and meticulous methodological approach developed in this study. From the perspective of stakeholders in the PHC system of care in remote areas, quality indicators are credible and provide potential for transferability to other contexts. This study brings information that has the potential to identify gaps in and implement solutions adapted to the context.
authors.affiliation: Université du Québec à Rimouski, Lévis, Québec, Canada. lily_lessard@uqar.ca.
authors.forename: Lily
authors.initials: L
authors.lastname: Lessard
authors.affiliation: Centre de Recherche du Chum, Montréal, Québec, Canada. louise.fournier@umontreal.ca.
authors.forename: Louise
authors.initials: L
authors.lastname: Fournier
authors.affiliation: Institut National de Santé Publique du Québec, Rimouski, Québec, Canada. josee.gauthier@inspq.qc.ca.
authors.forename: Josée
authors.initials: J
authors.lastname: Gauthier
authors.affiliation: Institut Universitaire de Recherche et de Formation en Soins, Lausanne University, Lausanne, Swirzerland. diane.morin@unil.ch.
authors.forename: Diane
authors.initials: D
authors.lastname: Morin
mesh_terms: D003866:Depressive Disorder / Q000628:therapy*; D057286:Electronic Health Records; D005240:Feasibility Studies; D006302:Health Services Research; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D019982:Organizational Case Studies; D010043:Outcome and Process Assessment, Health Care; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D011792:Quebec; D012424:Rural Population
keywords: Allied Health; Assessment; Community-Controlled Health Services; Determinants of Health; Emergency Care; Evidence-based Care; General/Family Practice; Health Service reform; Indigenous Health Worker; Management/Administration; Medical; North America; Nursing; Practice Tips; Primary Health Care; Procedures; Professional conduct; Psychiatry; Psychology; Public Health; Researcher; Workforce