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Improving Equity Through Primary Care: Proceedings of the 2019 Toronto International Conference on Quality in Primary
Braden O'Neill1, Robert Ferrer2, Patricia O'Brien2
1Department of Family and Community Medicine, North York General Hospital, Toronto, Ontario, Canada (O'Neill); Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada (O'Neill, O'Brien, Kidd, Kiran); Department of Family and Community Medicine, UT Health San Antonio, San Antonio, Texas (Ferrer); UT Health School of Public Health, San Antonio, Texas (Ferrer); General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom (Watt); Department of Family and Community Medicine and Social Interventions Research and Evaluation Network (SIREN), University of California, San Francisco, California (Gottlieb); Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Pinto, Kiran); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Insti tute of St Michael's Hospital, Toronto, Ontario, Canada (Pinto, Kiran); Department of Public Health and Primary Care, Ghent University, Gent, Belgium (Willems); Community Health Centre Watersportbaan, Gent, Belgium (Willems); Aboriginal and Torres Strait Islander Community Health Service Brisbane, Queensland, Australia (Currie, Leitch); Hearing Australia, Macquarie University, Sydney, Australia (Currie); University of Queensland, St Lucia, Queensland, Australia (Leitch); Provincial Patient Family Advisory Council, Ontario, Canada (Zsager); Inner City Family Health Team, Toronto, Ontario, Canada (Zsager); Canadian and Toronto Alliance to End Homelessness, Totonto, Ontario, Canada (Zsager); Homeless Connect Toronto, Toronto, Ontario, Canada (Zsager); Coordinator, Voices from the Street, Toronto, Ontario, Canada (Harriott); Principal Medical Advisor & Deputy Chief Medical Officer, Department of Health, Australia, Woden, Canberra, Australia (Kidd); Australian National University, Canberra, Australia (Kidd); World Health Organization Collaborating Centre on Family Medicine and Primary Care, Toronto, Ontario, Canada (Kidd, Kiran, O'Brien, O'Neill, Pinto); Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia (Kidd); Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, Australia (Kidd); Health Quality Ontario, Toronto, Ontario, Canada (Kiran); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Kiran) braden.oneill@nygh.on.ca.
Abstract:
Health equity allows people to reach their full health potential and receive high-quality care that is appropriate for them and their needs, no matter where they live, what they have, or who they are. It is a core element of quality in health care. Around the world, there are many efforts to improve equity through primary care. In order to advance these efforts, it is important to share successes and challenges. Building on our work with international stakeholders to identify key primary care research priorities, we organized the Toronto International Conference on Quality in Primary Care that was held on November 16, 2019. Participants from 8 countries took part. Key recommendations included the establishment of continuous relationships between providers and patients over time, relationships between providers in the health and social sectors, and resources supported proportionally to patient need. Solutions must be generated using team-based approaches that explicitly include people with who have experienced discrimination. Progress will require confronting structural determinants including racism, capitalism, and colonialism. Conference participants suggested practical solutions, such as developing a public transportation program for rural residents to improve community building and the ability to attend medical appointments, and identifying patients who have recently missed clinic visits that may benefit from additional care. These approaches will need to be evaluated through high-quality research and quality improvement, with a knowledge translation that facilitates sustainability and expansion across settings.
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