Navigation Links
Study questions whether Ontario's primary health care reforms serve the sick and poor
Date:5/26/2009

TORONTO, May 25, 2009 Ontario has invested millions of dollars into the healthcare system in response to a serious doctor shortage. But despite improvements in primary care, a study out of the Institute for Clinical Evaluative Sciences (ICES) has found Ontario's chronically sick and poor are the least likely to benefit from the investments.

In response to a serious doctor shortage, Ontario has undertaken major investments in new models of care provided by family doctors and other health workers. The first two models that were widely available to Ontario's doctors, the Family Health Network (FHN) and the Family Health Group (FHG) both have after-hours care requirements and incentives for a host of services including prevention, mental health care, smoking cessation and enhanced management of chronic diseases. The major difference between these models is that FHN doctors are paid mostly through an annual payment per registered patient, based on a person's age and sex, called a capitation payment. Under this system, the doctor gets paid regardless of how many visits the patient makes. FHG doctors continue to be paid mostly through enhanced fee-for-service, a system that pays only when patients make a visit to a doctor.

Compared with doctors who are paid per visit, doctors who are paid standard annual fees (FHN or the capitation group) had:

  • Enrolled healthier patients
  • Enrolled 30 per cent fewer new patients who didn't previously have family doctors
  • Provided 32 per cent less after-hours care

In addition, their patients had a 20 per cent higher rate of emergency department visits.

"As far as we could tell, this situation was present before the doctors joined their groups and didn't change as a result of capitation. This means that the capitation model attracted doctors with these kinds of practices. Both of the new models enrolled patients who were wealthier than average in their communities. While the capitation model provides an alternative to fee-for-service practice, its incentives may need to be altered so that its benefits can be made available to all Ontarians," says Dr. Rick Glazier, ICES Scientist and lead researcher.

The study looked at 4,060 doctors with nearly 3 million patients between September, 2005 and August, 2006.

Author affiliations: ICES (Glazier, Klein-Geltink, Kopp, Sibley); St. Michael's Hospital Centre for Research on Inner City Health and Department of Family and Community Medicine (Glazier), the University of Toronto Department of Family and Community Medicine (Glazier) and Dalla Lana School of Public Health (Glazier), Ontario.

The study "A population-based evaluation of large-scale primary care reform models" is in the May 25, 2009 issue of CMAJ.


'/>"/>

Contact: Deborah Creatura
Deborah.Creatura@ices.on.ca
416-480-4780
Institute for Clinical Evaluative Sciences
Source:Eurekalert

Related medicine news :

1. National study finds youth baseball-related injuries down 25 percent
2. NEJM study finds drug-eluting stents more effective than bare-metal stents in heart attack patients
3. Study Demonstrates Internet Risks for Teen Girls
4. Mayo study finds that team preop briefing improves communication, reduces errors
5. Arthritis drug might prove effective in fighting the flu, study suggests
6. Newborns of South Asian and East Asian descent misclassified as underweight at birth: Study
7. Mayo Study Finds That Team Preop Briefing Improves Communication, Reduces Errors
8. Thumbs Up at ARVO for Diaton Tonometer - New Through Eyelid Glaucoma Test Clinical Study Presented, Results as Accurate as Gold Standard
9. Refusing Immunizations Puts Children at Increased Risk of Pertussis Infection, Kaiser Permanente Study Finds
10. Study: Lower Legal Drinking Age Increases Poor Birth Outcomes
11. Study: Lower legal drinking age increases poor birth outcomes
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:1/18/2017)... ... January 18, 2017 , ... ... that their Vice President of Franchise Development, Paula Turner Pizarro, was recently featured ... program, which features the insights of top business leaders from across the globe, ...
(Date:1/18/2017)... ... January 18, 2017 , ... At Hallmark Nameplate, their commitment to quality ... achieved certification to ISO 13485. This certification is another way they are making constant ... and services that they need. , The ISO 13485 Certification is a major accomplishment ...
(Date:1/18/2017)... ... January 18, 2017 , ... Michael J. Hennessy ... for its Center for Biosimilars, announced Michael J. Hennessy Associates, Inc. President Michael ... field of biosimilars through thought leader interaction in, live video and interactive digital ...
(Date:1/18/2017)... ... January 18, 2017 , ... During pregnancy, ... to enamel erosion, and those dental problems can increase the risk of pregnancy ... pregnant women are failing to get the dental care they need. Agoura Hills ...
(Date:1/17/2017)... ... ... Anesthesia Progress – Everyone wants less pain during dental surgery, ... each patient. Dentists have several general anesthesia alternatives and finding the right option can ... Dental College in Tokyo, Japan wanted to find out which anesthetic was the better ...
Breaking Medicine News(10 mins):
(Date:1/17/2017)... YORK , Jan. 17, 2017 EU5 ... GlobalData,s new report, "EU5 Glucose Monitoring Market Outlook ... Glucose Monitoring market. The report provides value, in millions ... (USD) within market segments - Blood Glucose Meters, Blood ... provides company shares and distribution shares data for each ...
(Date:1/17/2017)... 17, 2017 Paragon Bioservices received a multiple-award, ... services for a variety of National Institute ... product development activities. The IDIQ mechanism will allow ... task order awards up to $159 million. ... and process development of biopharmaceuticals, is one of ...
(Date:1/17/2017)... Pa. , Jan. 17, 2017  Pennsylvania ... today announced applications for medical marijuana growers/processors and ... Medical Marijuana Program website . Permit applications will ... 2017. "This is an important step ... who desperately need it," Secretary Murphy said. "We,ve ...
Breaking Medicine Technology: