ICES | Primary Care Models in Ontario English - page 36

Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Department Use, 2008/09 to 2009/10
These findings also provide implications for
evaluation and research. The December 2011
report from the Ontario Auditor General noted
that the Ministry of Health and Long-Term
Care “…had not yet conducted any formal
analysis of whether the expected benefits of
these more costly alternative funding
arrangements have materialized.”
In the
same report, the challenges of doing that type
of analysis, as well as the complexity of
primary care models and payments in
Ontario, were acknowledged. There are no
true experiments and few longitudinal
analyses available to understand the impact
of new primary care models
and these are
much needed to help separate causes from
effects. Investments may have positive effects
that are not easily discerned in province-wide
trends, such as the reversal of the shrinking
primary care physician workforce after
2000/01, without which access to care may
have worsened rather than remained the
Comparisons with other Canadian
jurisdictions would be valuable, as would
comparisons with primary care reforms in
other developed countries. Strong primary
care is the foundation of high-performing
health systems
but how best to organize
primary care is not as well understood. Each
model of primary care appears to have both
strengths and weaknesses.
The details of
capitation payment schemes may be
especially important for ensuring timely
access to care and the inclusion of
disadvantaged and sicker populations. It is
extremely challenging to understand what
mix of models is best in order to meet
population and health system needs. Very
little work has been done to understand
value for money in Ontario’s primary
care models
and such studies are
long overdue.
“Very little work has been done to
understand value for money in
Ontario’s primary care models and
such studies are long overdue.”
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