Institute for Clinical Evaluative Sciences. (2012). Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Department Use, 2008/09 to 2009/10. Glazier, R.H., Zagorski, B.M., & Rayner, J.: Toronto, ON. Retrieved from www.santepop.qc.ca/url.php?i=14758&f=News&l=En.
“ISSUE: Are there differences between Ontario’s primary care models in who they serve and how often their patients/clients go to the emergency department (ED)?
STUDY: This study examined patients/clients enrolled in: Community Health Centres (CHCs, a salaried model), Family Health Groups (FHGs, a blended fee-for-service model), Family Health Networks (FHNs, a blended capitation model), Family Health Organizations (FHOs, a blended capitation model), Family Health Teams (FHTs, an interprofessional team model composed of FHNs and FHOs), ‘Other’ smaller models combined, as well as those who did not belong to a model. Electronic record encounter data (for CHCs) and routinely collected health care administrative data were used to examine sociodemographic composition, patterns of morbidity and comorbidity (case mix) and ED use. ED visits rates were adjusted to account for differences in location and patient/client characteristics.
- Compared with the Ontario population, CHCs served populations that were from lower income neighbourhoods, had higher proportions of newcomers and those on social assistance, had more severe mental illness and chronic health conditions, and had higher morbidity and comorbidity. In both urban and rural areas, CHCs had ED visit rates that were considerably lower than expected.
- FHGs and ‘Other’ models had sociodemographic and morbidity profiles very similar to those of Ontario as a whole, but FHGs had a higher proportion of newcomers, likely reflecting their more urban location. Both urban and rural FHGs and ‘Other’ models had lower than expected ED visits.
- FHNs and FHTs had a large rural profile, while FHOs were similar to Ontario overall. Compared with the Ontario population, patients in all three models were from higher income neighbourhoods, were much less likely to be newcomers, and less likely to use the health system or have high comorbidity. ED visits were higher than expected in all three models.
- Those who did not belong to one of the models of care studied were more likely to be male, younger, make less use of the health system and have lower morbidity and comorbidity than those enrolled in a model of care. They had more ED visits than expected.”