Continuity and Discontinuity in the Care Pathways of People with Complex Health Issues: Perceptions of Occupational Therapists – An Exploratory Study

Abstract

Since the creation of a health system financed by public funds and managed by the Ministry of Health, the Quebec health network has undergone numerous changes. For example, changes were made in early 2000 in order to improve the accessibility and continuity of healthcare available to Quebecers. Despite the concern of the Ministry to improve continuity of care, problems persist for people with complex health problems. Indeed, individuals struggling with comorbidity – e.g., with both physical and mental health problems – are more likely to experience discontinuities in their health care trajectories (i.e., discontinuity in their access to care), constituting an inadequate response to their needs. To understand the experiences of occupational therapists that serve such clients, an exploratory study was conducted. The purpose of this research was to explore perceptions of occupational therapists about continuity and discontinuity in the care trajectories of these clients. Occupational therapists identified the reasons which, in their opinion, explained the discontinuities in the trajectory of care individuals with complex health problems, and some of the negative consequences of these discontinuities; they also noted ways to improve the continuity of care for these clients. Taking into account the perceptions of occupational therapists is important in order to improve care for people with complex health problems.