Access to a regular primary care provider is essential to quality care. In Canada, where 15 % of patients are unattached (i.e., without a regular provider), centralized waiting lists (CWLs) help attach patients to a primary care provider (family physician or nurse practitioner). Previous studies reveal mechanisms needed for CWLs to work, but focus mostly on CWLs for specialized health care. We aim to better understand how to design CWLs for unattached patients in primary care.

In this study, a logic analysis compares empirical evidence from a qualitative case study of CWLs for unattached patients in seven Canadian provinces to programme theory derived from a realist review on CWLs. Data is analyzed using context-intervention-mechanism-outcome configurations.

Results identify mechanisms involved in three components of CWL design: patient registration, patient prioritization, and patient assignment to a provider for attachment. CWL programme theory is revised to integrate mechanisms specific to primary care, where patients, rather than referring providers, are responsible for registering on the CWL, where prioritization must consider a broad range of conditions and characteristics, and where long-term acceptability of attachment is important. The study provides new insight into mechanisms that enable CWLs for unattached patients to work.

获得正规的初级保健提供者对于优质保健至关重要。在加拿大，有 15% 的患者处于独立状态（即没有常规提供者），集中等候名单 (CWL) 有助于将患者与初级保健提供者（家庭医生或执业护士）联系起来。以前的研究揭示了 CWL 发挥作用所需的机制，但主要关注用于专业医疗保健的 CWL。我们旨在更好地了解如何为初级保健中的独立患者设计 CWL。

在这项研究中，逻辑分析将来自加拿大七个省份未依附患者的 CWL 定性案例研究的经验证据与从对 CWL 的现实主义评论得出的计划理论进行了比较。使用上下文干预机制结果配置分析数据。

结果确定了 CWL 设计的三个组成部分所涉及的机制：患者登记、患者优先排序和患者分配给提供者的附件。CWL 计划理论经过修订以整合特定于初级保健的机制，其中患者而不是转诊提供者负责在 CWL 上注册，优先级必须考虑广泛的条件和特征，以及依恋的长期可接受性重要的。该研究提供了新的见解，使独立患者的 CWL 能够工作的机制。