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Ontario primary care models: a descriptive study.

Logan McLeod1, Gioia Buckley1, Arthur Sweetman1

  • 1Lazaridis School of Business & Economics (McLeod), Wilfrid Laurier University, Waterloo, Ont.; Centre for Health Economics and Policy Analysis (Buckley) and Department of Economics (Sweetman), McMaster University, Hamilton, Ont.

CMAJ Open
|December 27, 2016
PubMed
Summary

Ontario

Area of Science:

  • Health Services Research
  • Primary Care Policy
  • Physician Practice Patterns

Background:

  • Ontario introduced diverse primary care models (2001-2006) including fee-for-service, capitation, and salary.
  • Models incorporated patient enrolment and minimum group sizes.
  • Study focuses on physician characteristics and practice patterns across these models.

Purpose of the Study:

  • To statistically describe physician characteristics, group size, and patient visit patterns across Ontario's primary care models.
  • To identify similarities and differences in primary care practice from a physician's perspective.

Main Methods:

  • Analysis of administrative data for fiscal year 2010/11.
  • Inclusion of data on physician characteristics, patient rostering, and visits.

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  • Descriptive comparison of practice patterns across different primary care models.

    • Main Results:

    • Fee-for-service physicians are more likely to work part-time, especially younger and female physicians.
    • Capitated model physicians are younger, less likely international medical graduates, and work in smaller, non-urban teams.
    • Physician patient loads varied, with fee-for-service seeing the fewest and non-capitated models seeing the most.

    Conclusions:

    • Physician and practice characteristics differ significantly across primary care models.
    • A substantial number of rostered patients receive care outside their registered physician group.
    • Group-based primary care models may have limited impact on care integration and continuity.