The CUP Study: Comparative analysis of centralized waitlist effectiveness, policies, and innovations for Connecting Unattached Patients to primary care providers

Background: People who have access to a regular primary care provider (family doctor or nurse practitioner) receive better and more appropriate care and have better health outcomes than those who do not. Across Canada, 15% of people do not have a regular provider (i.e. are "unattached patients"). Seven Canadian provinces have centralized waitlists that coordinate matching unattached patients to a primary care provider. These centralized waitlists work differently, and we conducted a previous study that compared how they work (e.g. How do unattached patients get on the waitlist? Are there any rules about who is allowed on the waitlist? What is the process for connecting patients on the list?). Some of the waitlists prioritize certain kinds of patients (e.g. people with chronic conditions or a mental illness) first. However, no one has studied yet how well centralized waitlists work. Goal: This study will compare centralized waitlists in NS, QC, and ON to see how effective they are at connecting unattached patients to primary care providers. Methods: We will use waitlist and administrative data to compare the effectiveness of the waitlists. We will also analyze policies in each province that might impact the waitlists' effectiveness. We will also gather information on other programs, besides centralized waitlists, that connect unattached patients to primary healthcare services. Finally, we will interview patients who have been attached to a provider through a centralized waitlist and providers who take patients from centralized waitlists. By using a variety of methods, we will be able to compare the three centralized waitlists and understand why they have different effectiveness. We will bring the findings to meetings with stakeholders (e.g. policymakers who oversee the waitlists, unattached patients, primary care providers) in each of the three provinces for their feedback. At the end of the study, we will share the findings with stakeholders from all provinces.