title: Protocol for determining primary healthcare practice characteristics, models of practice and patient accessibility using an exploratory census survey with linkage to administrative data in Nova Scotia, Canada.
abstract: There is little evidence on how primary care providers (PCPs) model their practices in Nova Scotia (NS), Canada, what services they offer or what accessibility is like for the average patient. This study will create a database of all family physicians and primary healthcare nurse practitioners in NS, including information about accessibility and the model of care in which they practice, and will link the survey data to administrative health databases.
  
  
  
  3 census surveys of all family physicians, primary care nurse practitioners (ie, PCPs) and their practices in NS will be conducted. The first will be a telephone survey conducted during typical daytime business hours. At each practice, the person answering the telephone will be asked questions about the practice's accessibility and model of care. The second will be a telephone survey conducted after typical daytime business hours to determine what out-of-office services PCP practices offer their patients. The final will be a tailored fax survey that will collect information that could not be obtained in the first 2 surveys plus new information on scope of practice, practice model and willingness to participate in research. Survey data will be linked with billing data from administrative health databases. Multivariate regression analysis will be employed to assess whether access and availability outcome variables are associated with PCP and model of practice characteristics. Negative binomial regression analysis will be employed to assess the association between independent variables from the survey data and health system use outcomes from administrative data.
  
  
  
  This study has received ethical approval from the Nova Scotia Health Authority and the Health Data Nova Scotia Data Access Committee. Dissemination approached will include stakeholder engagement at local and national levels, conference presentations, peer-reviewed publications and a public website.
authors.affiliation: Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Emily Gard
authors.initials: EG
authors.lastname: Marshall
authors.affiliation: Department of Family Practice, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gibson
authors.affiliation: Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Beverley
authors.initials: B
authors.lastname: Lawson
authors.affiliation: Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Frederick
authors.initials: F
authors.lastname: Burge
mesh_terms: D016208:Databases, Factual; D019538:Health Care Surveys / Q000379:methods* / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D017146:Models, Organizational; D009674:Nova Scotia; D009722:Nurse Practitioners / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration* / Q000706:statistics & numerical data; D012107:Research Design
keywords: PRIMARY CARE