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Who gets access to an interprofessional team-based primary care programme for patients with complex health and social
Sydney Jopling1, Walter P Wodchis1, Jennifer Rayner1,2,3
1Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Objectives:
To determine whether a voluntary referral-based interprofessional team-based primary care programme reached its target population and to assess the representativeness of referring primary care physicians.
Design:
Cross-sectional analysis of administrative health data.
Setting:
Ontario, Canada.
Intervention:
TeamCare provides access to Community Health Centre services for patients of non-team physicians with complex health and social needs.
Participants:
All adult patients who participated in TeamCare between 1 April 2015 and 31 March 2017 (n=1148), and as comparators, all non-referred adult patients of the primary care providers who shared patients in TeamCare (n=546 989), and a 1% random sample of the adult Ontario population (n=117 753).
Results:
TeamCare patients were more likely to live in lower income neighbourhoods with a higher degree of marginalisation relative to comparison groups. TeamCare patients had a higher mean number of diagnoses, higher prevalence of all chronic conditions and had more frequent encounters with the healthcare system in the year prior to participation.
Conclusions:
TeamCare reached a target population and fills an important gap in the Ontario primary care landscape, serving a population of patients with complex needs that did not previously have access to interprofessional team-based care.
Strengths And Limitations:
This study used population-level administrative health data. Data constraints limited the ability to identify patients referred to the programme but did not receive services, and data could not capture all relevant patient characteristics.
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