Abstract
BackgroundImproving health system value and efficiency are considered major policy priorities internationally. Ontario has undergone a primary care reform that included introduction of interprofessional teams. The purpose of this study was to investigate the relationship between receiving care from interprofessional versus non-interprofessional primary care teams and ambulatory care sensitive condition (ACSC) hospitalizations and hospital readmissions.MethodsPopulation-based administrative databases were linked to form data extractions of interest between the years of 2003–2005 and 2015–2017 in Ontario, Canada. The data sources were available through ICES. The study design was a retrospective longitudinal cohort. We used a “difference-in-differences” approach for evaluating changes in ACSC hospitalizations and hospital readmissions before and after the introduction of interprofessional team-based primary care while adjusting for physician group, physician and patient characteristics.ResultsAs of March 31st, 2017, there were a total of 778 physician groups, of which 465 were blended capitation Family Health Organization (FHOs); 177 FHOs (22.8%) were also interprofessional teams and 288 (37%) were more conventional group practices (“non-interprofessional teams”). In this period, there were a total of 13,480 primary care physicians in Ontario of whom 4848 (36%) were affiliated with FHOs—2311 (17.1%) practicing in interprofessional teams and 2537 (18.8%) practicing in non-interprofessional teams. During that same period, there were 475,611 and 618,363 multi-morbid patients in interprofessional teams and non-interprofessional teams respectively out of a total of 2,920,990 multi-morbid adult patients in Ontario. There was no difference in change over time in ACSC admissions between interprofessional and non-interprofessional teams between the pre- and post intervention periods. There were no statistically significant changes in all cause hospital readmission s between the post- and pre-intervention periods for interprofessional and non-interprofessional teams.ConclusionsOur study findings indicate that the introduction of interprofessional team-based primary care was not associated with changes in ACSC hospitalization or hospital readmissions. The findings point for the need to couple interprofessional team-based care with other enablers of a strong primary care system to improve health services utilization efficiency.
Highlights
Improving health system value and efficiency are considered major policy priorities internationally
Our study findings indicate that the introduction of interprofessional team-based primary care was not associated with changes in ambulatory care sensitive conditions (ACSCs) hospitalization or hospital readmissions
While health system costs continue to be a challenge across jurisdictions, hospitalizations for ambulatory care sensitive conditions (ACSCs) and hospital readmissions have been a focus for policymakers [3,4,5,6]
Summary
Improving health system value and efficiency are considered major policy priorities internationally. The purpose of this study was to investigate the relationship between receiving care from interprofessional versus noninterprofessional primary care teams and ambulatory care sensitive condition (ACSC) hospitalizations and hospital readmissions. While health system costs continue to be a challenge across jurisdictions, hospitalizations for ambulatory care sensitive conditions (ACSCs) and hospital readmissions have been a focus for policymakers [3,4,5,6]. Multi-morbid patients continue to be a key focus from a clinical care and population health perspective [13,14,15,16]. Interprofessional team-based care may have an important role to play in caring for multi-morbid patients by offering a collaborative approach to prevent ACSC hospitalization and hospital readmissions
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
