ICES | Primary Care Models in Ontario English - page 7

Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Department Use, 2008/09 to 2009/10
Executive Summary
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)?
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.
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