{"id":1914,"date":"2022-09-13T00:00:00","date_gmt":"2022-09-13T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/patient-clustering-in-primary-care-settings-outcomes-and-quality-of-care\/"},"modified":"2023-06-14T19:27:12","modified_gmt":"2023-06-14T23:27:12","slug":"patient-clustering-in-primary-care-settings-outcomes-and-quality-of-care","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patient-clustering-in-primary-care-settings-outcomes-and-quality-of-care\/","title":{"rendered":"Patient clustering in primary care settings: outcomes and quality of care"},"content":{"rendered":"<p><strong>Objective<\/strong> &#x2014; To determine whether neighbours who share the same family physicians have better cardiovascular and healthcare outcomes.<\/p>\n<p><strong>Design<\/strong> &#x2014; Retrospective cohort study using administrative health databases.<\/p>\n<p><strong>Setting<\/strong> &#x2014; Ontario.<\/p>\n<p><strong><br \/>\nParticipants<\/strong> &#x2014; The study population included 2,690,482 adult patients cared for by 1710 family physicians.<\/p>\n<p><strong><br \/>\nInterventions<\/strong> &#x2014; Adult residents of Ontario were linked to their family physicians and the geographic distance between patients in the same panel or list was calculated. Using distance between patients within a panel to stratify physicians into quintiles of panel proximity, physicians and patients from close-proximity practices were compared with those from more-distant-proximity practices. Age- and sex-standardized incidence rates and hazard ratios from cause-specific hazards regression models were determined.<\/p>\n<p><strong><br \/>\nMain Outcome Measures<\/strong> &#x2014; The occurrence of a major cardiovascular event during a 5-year follow-up period (2008 to 2012).<\/p>\n<p><strong><br \/>\nResults<\/strong> &#x2014; Patients of panels in the closest-proximity quintile lived an average of 3.9 km from the 10 closest patients in their panel compared with 12.4 km for the 10 closest patients of panels in the distant-proximity quintile. After adjusting for various patient and physician characteristics, patients in the most-distant-proximity practices had a 24% higher rate of cardiovascular events (adjusted hazard ratio=1.24 [95% CI 1.20 to 1.28], <em>P<\/em>&lt;.001) than patients in the closest-proximity practices. Age- and sex-standardized all-cause mortality and total per patient healthcare costs were also lowest in the closest-proximity quintile. In sensitivity analyses restricted to large urban communities and to White long-term residents, results were similar.<\/p>\n<p><strong><br \/>\nConclusion<\/strong> &#x2014; The better cardiovascular outcomes observed in close-proximity panels may be related to a previously unrecognized mechanism of social connectedness that extends the effectiveness of primary care practitioners.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objective &#x2014; To determine whether neighbours who share the same family physicians have better cardiovascular and healthcare outcomes. Design &#x2014; Retrospective cohort study using administrative health databases. Setting &#x2014; Ontario. Participants &#x2014; The study population included 2,690,482 adult patients cared for by 1710 family physicians. Interventions &#x2014; Adult residents of Ontario were linked to their [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-1914","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Hogg W, Kotb A, Chu A, Gozdyra P, Sivaswamy A, Fang J, Kendall CE, Tu J. <em>Can Fam Physician<\/em>. 2022; 68(9):671-80. Epub 2022 Sep 13.","source_url":"https:\/\/www.cfp.ca\/content\/68\/9\/671","ices_scientist":[1272,1157],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"6A4CB61F-BC02-4269-AC3D-29AEA85A1D86","sitecore_item_name":"Patient-clustering-in-primary-care-settings-outcomes-and-quality-of-care","sitecore_field_values":"{\n  \"Title\": \"Patient clustering in primary care settings: outcomes and quality of care\",\n  \"Short title\": \"Patient clustering in primary care\",\n  \"Summary\": \"The study objective was to determine whether neighbours who share the same family physicians have better cardiovascular and healthcare outcomes.\",\n  \"Citation\": \"<p>Hogg W, Kotb A, Chu A, Gozdyra P, Sivaswamy A, Fang J, Kendall CE, Tu J. <em>Can Fam Physician<\/em>. 2022; 68(9):671-80. Epub 2022 Sep 13. DOI: <a href=\"https:\/\/doi.org\/10.46747\/cfp.6809671\" title=\"opens external link\">https:\/\/doi.org\/10.46747\/cfp.6809671<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Objective<\/strong> &mdash; To determine whether neighbours who share the same family physicians have better cardiovascular and healthcare outcomes.<\/p>n<p><strong>Design<\/strong> &mdash; Retrospective cohort study using administrative health databases.<\/p>n<p><strong>Setting<\/strong> &mdash; Ontario.<\/p>n<p><strong>nParticipants<\/strong> &mdash; The study population included 2,690,482 adult patients cared for by 1710 family physicians.<\/p>n<p><strong>nInterventions<\/strong> &mdash; Adult residents of Ontario were linked to their family physicians and the geographic distance between patients in the same panel or list was calculated. Using distance between patients within a panel to stratify physicians into quintiles of panel proximity, physicians and patients from close-proximity practices were compared with those from more-distant-proximity practices. Age- and sex-standardized incidence rates and hazard ratios from cause-specific hazards regression models were determined.<\/p>n<p><strong>nMain Outcome Measures<\/strong> &mdash; The occurrence of a major cardiovascular event during a 5-year follow-up period (2008 to 2012).<\/p>n<p><strong>nResults<\/strong> &mdash; Patients of panels in the closest-proximity quintile lived an average of 3.9 km from the 10 closest patients in their panel compared with 12.4 km for the 10 closest patients of panels in the distant-proximity quintile. After adjusting for various patient and physician characteristics, patients in the most-distant-proximity practices had a 24% higher rate of cardiovascular events (adjusted hazard ratio=1.24 [95% CI 1.20 to 1.28], <em>P<\/em>&lt;.001) than patients in the closest-proximity practices. Age- and sex-standardized all-cause mortality and total per patient healthcare costs were also lowest in the closest-proximity quintile. In sensitivity analyses restricted to large urban communities and to White long-term residents, results were similar.<\/p>n<p><strong>nConclusion<\/strong> &mdash; The better cardiovascular outcomes observed in close-proximity panels may be related to a previously unrecognized mechanism of social connectedness that extends the effectiveness of primary care practitioners.<\/p>n<p><a href=\"https:\/\/www.cfp.ca\/content\/68\/9\/671\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{81017B85-00A9-49CC-8A47-390139E246AF}|{D45B3FD1-95D9-4C82-93F0-4C4B787BE676}|{956599EC-5699-41D3-9375-E0B6C25B12D5}\",\n  \"Posted Date\": \"20220913T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/September\/Patient-clustering-in-primary-care-settings-outcomes-and-quality-of-care"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Patient clustering in primary care settings: outcomes and quality of care<\/title>\n<meta name=\"description\" content=\"Objective &#x2014; To determine whether neighbours who share the same family physicians have better cardiovascular and healthcare outcomes. 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