RT Journal Article
SR Electronic
T1 Relational Continuity, Physician Payment, and Team-Based Primary Care in the Canadian Health Care System
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP jabfm.2022.220235R1
DO 10.3122/jabfm.2022.220235R1
A1 Kiran, Tara
A1 Green, Michael E.
A1 Bai, Li
A1 Latifovic, Lidija
A1 Khan, Shahriar
A1 Kopp, Alex
A1 Frymire, Eliot
A1 Glazier, Richard H.
YR 2023
UL http://www.jabfm.org/content/early/2023/01/03/jabfm.2022.220235R1.abstract
AB Purpose: Continuity is a core component of primary care and known to differ by patient characteristics. It is unclear how primary care physician payment and organization are associated with continuity.Methods: We analyzed administrative data from 7,110,036 individuals aged 16+ in Ontario, Canada who were enrolled to a physician and made at least 2 visits between October 1, 2017 and September 30, 2019. Continuity with physician and practice group was quantified using the usual provider of care index. We used log-binomial regression to assess the relationship between enrollment model and continuity adjusting for patient characteristics.Results: Mean physician and group continuity were 67.3% and 73.8%, respectively, for patients enrolled in enhanced fee-for-service, 70.7% and 76.2% for nonteam capitation, and 70.6% and 78.7% for team-based capitation. These differences were attenuated in regression models for physician-level continuity and group-level continuity. Older age was the most notable factor associated with continuity. Compared with those 16 to 34, those 80 and older had 1.45 times higher continuity with their physician.Conclusion: Our results suggest that continuity does not differ substantially by physician payment or organizational model among primary care patients who are formally enrolled with a physician in a setting with universal health insurance.