Health System Reform in Montreal: Impact on the Use of Day Surgery and on Surgical Patients and their Caregivers

This is an evaluation of the health system changes in Montreal, Quebec, in the late 1990s. We have estimated their effects for surgical patients with conditions amenable to day surgery. We contrasted the experiences of a cohort of such patients seen in 1996, at the beginning of the changes, with those of a second cohort seen in 1999, after adaptation to the changes was completed. Our results indicate that, while the reforms reduced the health system services used by patients, the patients' well-being was not reduced. The use of caregivers increased, though the individual caregiver's well-being was not reduced by the system changes.