Primary Care Organization and Performance

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Primary Care Organization and Performance

• Results from the Comparison of Models Study

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Project Team

• Investigators
• Dr. William Hogg
• Louise Ogilvie
• Doug Angus, PhD
• Betsy Kristjansson, PhD
• Dr. Doug Manuel
• Dr. Laura Muldoon
• Rose Anne Devlin, PhD
• Dr. Laura Muldoon

• Senior Project Members
• Simone Dahrouge, PhDc
• Meltem Tuna, PhD
• Melissa Dust, MSc
• Susan Efler, MSc
• Victoria Barham, PhD
• Olga Milliken, PhD
• Dr. Grant Russell
• Robert Geneau, PhD
• Dr. Sharon Johnston

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Research questions

• Compare the performance of models of primary care
  delivery
• Health Service Delivery
• Technical Quality of Care
• 2. Evaluate what organizational factors explain
  the difference?

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Models

• CHC (Salary) Community Health Centres
• FFS /FHG Fee-for-Service
• FHN (Blended payment) Family Health Networks
• HSO (Capitation) Health Service Organizations

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Ontarios models of primary care
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Design

• Cross sectional mixed methods study
• Set in Ontario 2005-2006
• Sample of 137 Primary care practices in four
  models of primary care delivery

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Study tools

• Patient waiting room survey (35-50 per site)
• Before the visit (experience of primary care)
• After the visit (report of consultation)
• Chart audit (30 per site)
• Technical quality of care

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Results
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Health Service Delivery
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Health Service Delivery
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Technical Quality of Care
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Technical Quality of Care
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Technical Quality of Care
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Efficiency Cost per patient
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Results

• Predicting performance

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Results
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Results
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Results
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Conclusions

• Differences in performance exist across models
• Organizational factors can be identified that
  impact performance

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