Table 2

Organizational survey questions to primary healthcare organization
Collaboration with PHC organization(s) Indicate whether your clinic has formal or informal arrangements with one or several PHC medical clinic(s) for the following activities:
Planning services offer (on-call activities, clinic hours, walk-in services, etc.)?
Access to technical services (e.g. radiology, laboratory)?
Exchange resources (e.g. loan of professionals)?
Referral or transfer of patients to general practitioners, specialists or other professionals?
Follow-up for hospitalized patients or patients seen at the clinic?
If you answered “yes” to any of the choices in the preceding question, identify the main primary healthcare clinic or clinics with which you have arrangements.
Collaboration with hospital(s) Indicate whether your clinic has formal or informal arrangements with one or several hospital(s) for the following activities:
Planning services offer (on call activities, clinic hours, walk-in services, etc.)?
Access to technical services (e.g. radiology, laboratory)?
Exchange resources (e.g. loan of professionals)?
Referral or transfer of patients to family physicians, specialists or other professionals?
Follow-up for hospitalized patients or patients seen at the clinic?
If you answered “yes” to any of the choices in the preceding question, identify the main hospital or hospitals with which you have arrangements.

Breton et al.

Breton et al. BMC Health Services Research 2013 13:262   doi:10.1186/1472-6963-13-262

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