Report

Mapping the future of primary healthcare research in Canada

Overview

Canada is embarking on widespread reform to the organization and delivery of its primary healthcare (PHC) system. These reforms come at a time when there is increasing awareness of the link between quality PHC and important health outcomes. The resulting focus upon PHC brings with it a need to ensure PHC research capacity: the research skills and infrastructure required to answer the core PHC questions confronting policy makers, system managers, healthcare providers and the public.

To evaluate Canada’s PHC research capacity, the Canadian Health Services Research Foun– dation (CHSRF) commissioned this study. Data were collected through a literature review and consultation with practitioners, researchers, policy makers and other experts from both Canada and abroad. We found widespread deficiencies in the sustainability and co-ordination of Canadian PHC research. PHC research has had little visibility with Canada’s main federal health research funder, the Canadian Institutes of Health Research (CIHR). While there has sometimes been considerable support for PHC capacity at the provincial level, such capacity has often been tied to specific, time-limited initiatives. At an individual level, young clini– cians and PhD scientists receive little encouragement to pursue PHC research careers. Those who do make a start have major problems securing mid-career support. Although the recent Primary Heath Care Transition Fund led to the emergence of quality research teams investigating PHC issues, many of these teams dissolved following the fund’s termination in March 2006.

Much of this situation could be traced back to the lack of dedicated funding support provided by national or provincial funding bodies for PHC research and career development.

Canada’s approach to PHC research contrasts with that found overseas. Many western nations, in particular the U.K. and Australia, are beginning to reap the benefits of co-ordinated strategies designed to nurture PHC research capacity. Many of these strategies mirror current Canadian initiatives to develop research capacity in nursing.

Canada needs to reinvigorate its PHC research sector through a co-ordinated strategy involving two core initiatives. These are:

  1. Formation of a Canadian co-ordinating body for primary healthcare research whose functions would include a PHC research information system to build on the current information dissemination activities of the CHSRF and of several provincial health research bodies.
  2. Targeted federal and provincial initiatives to fund PHC research. For maximum impact these should aim to provide operating grants directed at critical PHC questions; team grants to allow experienced researchers to collaborate and address strategically important PHC issues; support for PHC research chairs; and, most importantly, a co-ordinated program to foster sustainable careers for PHC clinician researchers and research scientists.