Article Figures & Data
Figures
- Figure 1.
Patient population included in analysis. Abbreviation: GP, general practitioner.
- Figure 2.
Mean continuity with the enrolling physician (A) and group (B) stratified by patient enrollment model and rurality. Continuity was calculated for all enrolled patients with 2 or more visits between October 1, 2017 and September 30, 2019. Abbreviation: FFS, fee-for-service.
Tables
- Table 1.
Demographic Characteristics for Enrolled Patients with 2 or More Primary Care Visits Between October 1, 2017 and September 30, 2019, Stratified by Patient Enrollment Model
Patient Enrollment Model Enhanced Fee-for-Service Nonteam Capitation Team-Based Capitation Total Characteristic n % n % n % n % Overall 2,617,415 100.0 2,520,998 100.0 1,971,623 100.0 7,110,036 100.0 Age group 16–34 696,614 26.6 563,986 22.4 440,491 22.3 1,701,091 23.9 35–49 673,824 25.7 553,155 21.9 409,415 20.8 1,636,394 23.0 50–64 702,216 26.8 713,931 28.3 540,275 27.4 1,956,422 27.5 65–79 417,025 15.9 518,891 20.6 435,816 22.1 1,371,732 19.3 80+ years 127,736 4.9 171,035 6.8 145,626 7.4 444,397 6.3 Sex Male 1,171,246 44.7 1,090,688 43.3 834,352 42.3 3,096,286 43.5 Female 1,446,169 55.3 1,430,310 56.7 1,137,271 57.7 4,013,750 56.5 Rurality index (RIO score) Urban (0 to 9) 2,332,217 89.1 1,935,125 76.8 1,075,389 54.5 5,342,731 75.1 Small town (10 to 39) 234,186 8.9 476,717 18.9 611,200 31.0 1,322,103 18.6 Rural (40+) 43,133 1.6 99,840 4.0 266,513 13.5 409,486 5.8 Missing 7,879 0.3 9,316 0.4 18,521 0.9 35,716 0.5 Number of visits over the 2-year period (October 1, 2017 to September 30, 2019) Mean (± SD) 2,617,415 10.2 (± 8.6) 2,520,998 7.2 (± 5.7) 1,971,623 6.6 (± 5.3) 7,110,036 8.1 (± 7.0) Median (IQR) 2,617,415 8 (5, 13) 2,520,998 6 (3, 9) 1,971,623 5 (3, 8) 7,110,036 6 (4, 10) 2 to 4 638,985 24.4 955,647 37.9 852,053 43.2 2,446,685 34.4 5 to 7 581,805 22.2 682,795 27.1 525,161 26.6 1,789,761 25.2 8 to 11 573,876 21.9 497,287 19.7 347,834 17.6 1,418,997 20.0 12+ 822,749 31.4 385,269 15.3 246,575 12.5 1,454,593 20.5 Comorbidity (ADG)* No/low comorbidity (0 to 4) 858,997 32.8 952,197 37.8 747,213 37.9 2,558,407 36.0 Moderate comorbidity (5 to 9) 1,288,707 49.2 1,197,334 47.5 923,890 46.9 3,409,931 48.0 High comorbidity (10+) 469,711 17.9 371,467 14.7 300,520 15.2 1,141,698 16.1 Morbidity (RUB)† Nonuser/healthy user (0 to 1) 48,480 1.9 58,553 2.3 44,857 2.3 151,890 2.1 Low morbidity (2) 314,417 12.0 344,800 13.7 263,735 13.4 922,952 13.0 Moderate morbidity (3) 1,539,271 58.8 1,465,091 58.1 1,105,677 56.1 4,110,039 57.8 High morbidity (4+) 715,247 27.3 652,554 25.9 557,354 28.3 1,925,155 27.1 Income quintile Low (1) 500,005 19.1 406,988 16.1 344,446 17.5 1,251,439 17.6 2 530,913 20.3 470,210 18.7 381,707 19.4 1,382,830 19.4 3 561,096 21.4 501,437 19.9 399,243 20.2 1,461,776 20.6 4 544,486 20.8 540,400 21.4 405,774 20.6 1,490,660 21.0 High (5) 476,908 18.2 598,482 23.7 437,860 22.2 1,513,250 21.3 Missing 4007 0.2 3,481 0.1 2,593 0.1 10,081 0.1 Long-term resident Yes 2,250,895 86.0 2,376,543 94.3 1,897,786 96.3 6,525,224 91.8 No 366,520 14.0 144,455 5.7 73,837 3.7 584,812 8.2 Abbreviations: IQR, interquartile range; RIO, Rurality Index for Ontario.
* Johns Hopkins Aggregated Diagnosis Group.
†Johns Hopkins Resource Utilization Band.
- Table 2.
Mean Continuity to the Enrolling Physician and Group by Patient Enrollment Model and Selected Demographic Characteristics for All Patients with 2 or More Primary Care Visits, October 1, 2017–September 30, 2019, Ontario, Canada
Enrolling Physician Enrolling Group Characteristic n Mean SD n Mean SD Overall 7,110,036 69.4 33.2 7,110,036 76.0 31.3 Enrollment model Enhanced fee-for-service 2,617,415 67.3 34.2 2,617,415 73.8 32.4 Nonteam capitation 2,520,998 70.7 32.3 2,520,998 76.2 31.1 Team-based capitation 1,971,623 70.6 32.8 1,971,623 78.7 30.0 Age group 16–34 1,701,091 57.0 35.5 1,701,091 64.8 35.2 35–49 1,636,394 66.0 33.6 1,636,394 73.3 32.1 50–64 1,956,422 74.0 31.1 1,956,422 80.2 28.7 65–79 1,371,732 79.0 28.3 1,371,732 84.4 25.6 80+ years 444,397 79.6 28.2 444,397 84.7 25.7 Sex Male 3,096,286 69.9 34.0 3,096,286 76.2 32.1 Female 4,013,750 69.0 32.5 4,013,750 75.8 30.7 Rurality index (RIO score) Urban (0 to 9) 5,342,731 67.7 33.6 5,342,731 74.2 32.1 Small town (10 to 39) 1,322,103 74.2 31.2 1,322,103 81.2 28.5 Rural (40+) 409,486 76.0 31.4 409,486 82.7 27.8 Missing 35,716 71.6 33.9 35,716 78.7 31.1 Number of visits over the 2-year period (October 1, 2017 to September 30, 2019) 2 to 4 2,446,685 69.4 36.1 2,446,685 76.1 33.9 5 to 7 1,789,761 69.8 31.9 1,789,761 76.4 30.2 8 to 11 1,418,997 70.1 30.9 1,418,997 76.6 29.2 12+ 1,454,593 68.2 31.6 1,454,593 74.9 30.2 Comorbidity (ADG)* No/low comorbidity (0 to 4) 2,558,407 70.1 35.5 2,558,407 76.5 33.4 Moderate comorbidity (5 to 9) 3,409,931 69.1 32.1 3,409,931 75.8 30.4 High comorbidity (10+) 1,141,698 68.8 30.8 1,141,698 75.6 29.3 Morbidity (RUB)† Nonuser/healthy user (0 to 1) 151,890 59.4 40.0 151,890 67.3 39.0 Low morbidity (2) 922,952 66.8 36.8 922,952 73.7 35.0 Moderate morbidity (3) 4,110,039 70.0 32.8 4,110,039 76.5 30.9 High morbidity (4+) 1,925,155 70.2 31.3 1,925,155 76.8 29.5 Income quintile Low (1) 1,251,439 68.7 34.2 1,251,439 75.0 32.5 2 1,382,830 69.6 33.4 1,382,830 76.2 31.6 3 1,461,776 69.4 33.1 1,461,776 76.1 31.3 4 1,490,660 69.2 32.8 1,490,660 76.0 31.0 High (5) 1,513,250 70.0 32.4 1,513,250 76.8 30.5 Missing 10,081 64.3 35.1 10,081 70.5 34.1 Long-term resident Yes 6,525,224 69.7 33.2 6,525,224 76.2 31.3 No 584,812 66.5 33.2 584,812 73.6 31.6 - Table 3.
Risk Ratios and 95% CIs for Regression Models Examining the Associations Between Patient Enrollment Model and Continuity to the Enrolling Physician or Group After Adjustment for Patient Characteristics. Continuity Was Calculated for All Patients with 2 or More Primary Care Visits Between October 1, 2017 and September 30, 2019
Enrolling Physician Enrolling Group Characteristic Risk Ratio Lower 95% CI Upper 95% CI P Value Risk Ratio Lower 95% CI Upper 95% CI P Value Enrollment Model Enhanced fee-for-service 1.000 1.000 Nonteam capitation 1.003 1.003 1.003 <0.001 0.994 0.994 0.995 <0.001 Team-based capitation 0.980 0.979 0.980 <0.001 1.003 1.002 1.003 <0.001 Age group 16–34 1.000 1.000 35–49 1.164 1.163 1.165 <0.001 1.134 1.134 1.135 <0.001 50–64 1.312 1.311 1.313 <0.001 1.243 1.242 1.244 <0.001 65–79 1.413 1.412 1.414 <0.001 1.316 1.315 1.316 <0.001 80+ years 1.447 1.446 1.448 <0.001 1.337 1.336 1.338 <0.001 Sex Male 1.000 1.000 Female 0.994 0.994 0.995 <0.001 1.001 1.001 1.002 <0.001 Rurality index (RIO score) Urban (0 to 9) 1.000 1.000 Small town (10 to 39) 1.071 1.070 1.071 <0.001 1.066 1.065 1.066 <0.001 Rural (40+) 1.084 1.083 1.084 <0.001 1.070 1.069 1.070 <0.001 Comorbidity (ADG)* No/low comorbidity (0 to 4) 1.145 1.144 1.146 <0.001 1.108 1.107 1.109 <0.001 Moderate comorbidity (5 to 9) 1.071 1.071 1.072 <0.001 1.056 1.056 1.057 <0.001 High comorbidity (10+) 1.000 1.000 Morbidity (RUB)† Nonuser/healthy user (0 to 1) 0.888 0.886 0.890 <0.001 0.918 0.916 0.920 <0.001 Low morbidity (2) 0.974 0.973 0.974 <0.001 0.982 0.981 0.983 <0.001 Moderate morbidity (3) 0.988 0.988 0.988 <0.001 0.991 0.990 0.991 <0.001 High morbidity (4+) 1.000 1.000 Income quintile Low (1) 1.000 1.000 2 1.000 1.000 1.001 0.899 0.991 0.991 0.992 <0.001 3 1.007 1.006 1.007 <0.001 1.003 1.002 1.003 <0.001 4 1.001 1.000 1.001 0.001 0.999 0.999 0.999 <0.001 High (5) 0.995 0.994 0.995 <0.001 0.994 0.993 0.994 <0.001 Long-term resident Yes 1.000 1.000 No 1.012 1.012 1.013 <0.001 1.020 1.019 1.020 <0.001 Abbreviations: CI, confidence interval; RIO, Rurality Index for Ontario.
↵* Johns Hopkins Aggregated Diagnosis Group.
† Johns Hopkins Resource Utilization Band.
Continuity Measure Enrolling Physician Enrolling Group Enrollment Model Risk Ratio Lower 95% CI Upper 95% CI Risk Ratio Lower 95% CI Upper 95% CI Overall Enhanced fee-for-service 1.000 1.000 Nonteam capitation 1.003 1.003 1.003 0.994 0.994 0.995 Team-based capitation 0.980 0.979 0.980 1.003 1.002 1.003 Urban Enhanced fee-for-service 1.000 1.000 Nonteam capitation 1.004 1.003 1.004 0.988 0.988 0.988 Team-based capitation 0.963 0.962 0.964 0.988 0.988 0.989 Small town Enhanced fee-for-service 1.000 1.000 Nonteam capitation 1.008 1.007 1.009 1.031 1.030 1.032 Team-based capitation 1.022 1.021 1.023 1.054 1.054 1.055 Rural Enhanced fee-for-service 1.000 1.000 Nonteam capitation 0.989 0.987 0.991 0.989 0.987 0.991 Team-based capitation 0.951 0.949 0.953 0.984 0.982 0.985 Male Enhanced fee-for-service 1.000 1.000 Nonteam capitation 1.002 1.001 1.003 0.992 0.992 0.993 Team-based capitation 0.981 0.981 0.982 0.999 0.999 1.000 Female Enhanced fee-for-service 1.000 1.000 Nonteam capitation 1.003 1.003 1.004 0.996 0.995 0.996 Team-based capitation 0.979 0.978 0.979 1.005 1.005 1.006 Abbreviation: CI, confidence interval.
In this issue
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- Article
- Abstract
- Introduction
- Methods
- Results
- Discussion
- Conclusion
- Acknowledgments
- Appendix Table 1. Risk Ratios and 95% CIs for the Associations Between Patient Enrollment Model and Continuity Stratified by Rurality (Urban, Small Town, Rural) and Sex (Male, Female) for Patients with 2 or More Primary Care Visits, October 1, 2017–September 30, 2019, Ontario, Canada
- Notes
- References
- Figures & Data
- References
- Info & Metrics