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 130
OP 141
DO 10.3122/jabfm.2022.220235R1
VO 36
IS 1
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/36/1/130.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.