Authors' objectives: Our objective was to characterize primary care models in Ontario by demographics, practice location and case mix and to examine ED use by patients/clients in each model before and after controlling for their characteristics.

Authors' recommendations: Ontario's primary care models serve different populations and are associated with different outcomes. A move away from fee-for-service reimbursement may be desirable for a high functioning health care system, but how alternate payment mechanisms are structured appears to matter a great deal. The largest current models of care have been costly but have had limited impact on population access to care, which was a key aim. The capitation and team models that have received the most new resources are looking after relatively advantaged groups and are associated with higher than expected ED visits. The payment and incentive structures underlying these models therefore require re-examination. The CHC model offers an attractive alternative in many respects, but CHCs serve a different role than the other primary care models and are resourced and governed quite differently. Where they fit within primary care in Ontario should also be the subject of further policy consideration. So far, little work has been done to understand value for money in Ontario's primary care models and such analyses are long overdue. Ontario's diversity of primary care models, if properly evaluated, can provide a wealth of information for policy makers. Decision-makers in Ontario and other provinces and countries are grappling with how to make health systems more effective and efficient. Ontario has a unique opportunity to redesign primary care by understanding and applying evidence about its many models of care. It is hoped that this report may help policy makers to understand how Ontario's primary care models relate to the types of patients served and the outcome of ED visits, with a view towards re-orienting existing resources and future investments.

Project Status: Completed

Year Published: 2012

URL for published report: http://www.ices.on.ca/file/ICES_Primary%20Care%20Models%20English.pdf

URL for additional information: http://www.ices.on.ca/webpage.cfm?site_id=1&org_id=68

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute for Clinical Evaluative Sciences

Contact Address: Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, G-Wing, Toronto ON, Canada, M5N 3M5. Tel: 416-480-4055; Fax: 416-480-6048

Contact Name: info@ices.on.ca

Contact Email: info@ices.on.ca

Copyright: Institute for Clinical Evaluative Sciences (ICES)