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Original Research

Quality assessment of primary care for common mental disorders in isolated communities: Taking advantage of health records

Submitted: 31 July 2014
Revised: 2 December 2014
Accepted: 11 December 2014
Published: 5 July 2015

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Author(s) : Lessard L, Fournier L, Gauthier J, Morin D.

Lily LessardLouise FournierJosée GauthierDiane Morin

Citation: Lessard L, Fournier L, Gauthier J, Morin D.  Quality assessment of primary care for common mental disorders in isolated communities: Taking advantage of health records. Rural and Remote Health (Internet) 2015; 15: 3224. Available: (Accessed 19 October 2017)


Introduction:  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.

Key words: community mental health services, health records, isolated rural area, methods, quality of patient care, rural health services.

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