Integrating oral health care services into primary care in Quebec

Background: Although integrated care is drawing considerable attention from health care policy makers, little is known about integration of oral health care services into primary care in Quebec. Therefore, the objective of this study was to compile information and compare the aspects of primary oral health care in two public health care organizations. Method: An environmental scan was carried out in one rural and one urban primary health care organizations in Quebec. Data were collected from organizations' websites, operational documents, observational notes on facility visits, primary care meeting minutes, online pages of professional orders and face to face interviews (N = 74) and focus groups (N = 5), between November 2016 and October 2018. Thematic and Prior's documentation analyses were used to analyse the data. Results: Three themes were identified: normative aspects of integrated care delivery, integration trajectories, and integration initiatives. In both organizations, the integration of oral health into primary care rooted in public health sectors and dental teams were the key players. While urban center showed informal linkages between dental and non-dental primary care providers, the rural organization succeeded in coordination processes, even though these were also informal. Conclusion: The majority of primary oral health care services are delivered in the public health sectors and the sustainability of integration initiatives in other primary health care sectors remains to be demonstrated. A better management of resources, as well as partnerships between public health care organizations and universities, could contribute to this integration.