scholarly journals Comparing Primary Care Interprofessional and Non-interprofessional Teams on Access to Care and Health Services Utilization in Ontario, Canada: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Wissam Haj-Ali ◽  
Brian Hutchison ◽  
Rahim Moineddin ◽  
Walter Wodchis ◽  
Rick Glazier
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Access To Care ◽  
Health Services Utilization ◽  
P Value ◽  
Emergency Department Use ◽  
Services Utilization ◽  
Interprofessional Teams ◽  
Primary Care Teams ◽  
After Hours

Abstract Background: Many countries, including Canada, have introduced primary care reforms to improve health system functioning and value. The purpose of this study was to examine the association between receiving care from interprofessional primary care teams and access to care and health services utilization. Methods: We conducted a retrospective cohort study linking population-based administrative databases to Ontario’s Health Care Experience Survey (HCES) between 2012 and 2018. We adjusted for physician group characteristics as well as individual physician and patient characteristics while assessing the relationship between receiving care from interprofessional teams and the outcomes of interest.Results: As of March 31st, 2015, there were 465 physician groups with HCES respondents of which 177 (38.0%) were interprofessional teams and 288 (62.0%) were non-interprofessional teams in the same blended capitation reimbursement model. In this period, there were 4,518 physicians with HCES respondents, of whom 2,131 (47.2%) were in interprofessional teams and 2,387 (52.8%) were in non-interprofessional teams. There were 10,102 HCES respondents included in this study, of whom 42.4% were in interprofessional teams and 42.3% were in non-interprofessional teams. After adjustment, we found that being in an interprofessional team was associated with an increase in the odds of patients reporting same/next day access to care by 12.0% (OR=1.12 CI=1.00 to 1.24 p-value 0.0436) and a decrease in the odds of patients reporting walk-in clinic use by 16% (OR=0.84 CI=0.75 to 0.94 p-value 0.0019). After adjustment, there were no significant differences in patient-reported after-hours access to care and emergency department use.Conclusions: Ontario has invested heavily in interprofessional primary care teams. As compared to patients in non-interprofessional teams, patients in interprofessional teams self-reported more timely access to care and less walk-in clinic use but no significant difference in self-reported access to after-hours care or in emergency department use. For jurisdictions aiming to expand physician voluntary participation in interprofessional teams, our study results inform expectations around access to care and health services utilization.

scholarly journals Comparing primary care Interprofessional and non-interprofessional teams on access to care and health services utilization in Ontario, Canada: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wissam Haj-Ali ◽  
Brian Hutchison ◽  
Rahim Moineddin ◽  
Walter P. Wodchis ◽  
Richard H. Glazier
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Access To Care ◽  
Retrospective Cohort ◽  
Emergency Department Use ◽  
Services Utilization ◽  
Interprofessional Teams ◽  
Primary Care Teams ◽  
Patient Reported ◽  
After Hours

Abstract Background Many countries, including Canada, have introduced primary care reforms to improve health system functioning and value. The purpose of this study was to examine the association between receiving care from interprofessional primary care teams and after-hours access to care, patient-reported walk-in clinic visits and emergency department use. Methods We conducted a retrospective cohort study linking population-based administrative databases to Ontario’s Health Care Experience Survey (HCES) between 2012 and 2018. We adjusted for physician group characteristics as well as individual physician and patient characteristics while assessing the relationship between receiving care from interprofessional teams and the outcomes of interest. Results As of March 31st, 2015, there were 465 physician groups with HCES respondents of which 177 (38.0%) were interprofessional teams and 288 (62.0%) were non-interprofessional teams in the same blended capitation reimbursement model. In this period, there were 4518 physicians with HCES respondents, of whom 2131 (47.2%) were in interprofessional teams and 2387 (52.8%) were in non-interprofessional teams. There were 10,102 HCES respondents included in this study, of whom 42.4% were in interprofessional teams and 42.3% were in non-interprofessional teams. After adjustment, we found that being in an interprofessional team was associated with an increase in the odds of patients reporting same/next day access to care by 12.0% (OR = 1.12 CI = 1.00 to 1.24 p-value 0.0436) and a decrease in the odds of patients reporting walk-in clinic use by 16% (OR = 0.84 CI = 0.75 to 0.94 p-value 0.0019). After adjustment, there were no significant differences in patient-reported after-hours access to care and emergency department use. Conclusions Ontario has invested heavily in interprofessional primary care teams. As compared to patients in non-interprofessional teams, patients in interprofessional teams self-reported more timely access to care and less walk-in clinic use but no significant difference in self-reported access to after-hours care or in emergency department use. For jurisdictions aiming to expand physician voluntary participation in interprofessional teams, our study results inform expectations around access to care and health services utilization.

scholarly journals Health services utilization by depressive patients identified by the MINI questionnaire in a primary care setting

2005 ◽  
Vol 23 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Pesach Shvartzman ◽  
Zeev Weiner ◽  
Daniel Vardy ◽  
Michael Friger ◽  
Michael Sherf ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Care Setting ◽  
Primary Care Setting ◽  
Health Services Utilization ◽  
Services Utilization ◽  
Depressive Patients

Impact of behavioral health problems on access to care and health services utilization

2004 ◽  
Vol 32 (2) ◽  
pp. 113-129 ◽  
Author(s):  
Katherine S. Virgo ◽  
Nathan K. Risk ◽  
Edward L. Spitznagel ◽  
Rumi Kato Price
Keyword(s):  
Health Services ◽  
Access To Care ◽  
Behavioral Health ◽  
Health Services Utilization ◽  
Health Problems ◽  
Services Utilization

Health needs, utilization of services and access to care among Medicaid and uninsured patients with chronic disease in health centres

2019 ◽  
Vol 24 (3) ◽  
pp. 172-181 ◽  
Author(s):  
Hailun Liang ◽  
May A. Beydoun ◽  
Shaker M. Eid
Keyword(s):  
Health Services ◽  
Access To Care ◽  
Prescription Drugs ◽  
Chronic Conditions ◽  
Health Services Utilization ◽  
Unmet Need ◽  
Uninsured Patients ◽  
Services Utilization ◽  
Health Centres ◽  
Source Of Care

Introduction Understanding the role of Medicaid for health centre patients with chronic diseases can aid policymakers in designing and improving programmes to effectively meet the needs of this vulnerable segment of the population. This study compares the number of chronic conditions, health services utilization and access to care between patients with Medicaid coverage and uninsured patients seen at US health centres. Methods We used data from the 2014 Health Center Patient Survey. Measures included number of chronic conditions, number of physician visits, number of prescription drugs used, access to a usual source of care, the receipt of a routine checkup, unmet need for care and unmet need for prescription drugs. We conducted bivariate analyses to determine differences of outcome measures between the Medicaid and uninsured patient groups. Multiple linear and logistic regression models were conducted to test associations of Medicaid and other health-related factors with outcome measures. Results Bivariate results indicated there were no differences between Medicaid and uninsured patients in number of chronic diseases, having a usual source of care and receipt of a routine checkup. Significant differences existed in health services utilization measures and unmet health needs measures. After controlling for confounding factors, the differences in these measures were still apparent. Uninsured status was linked to a reduced physician visit frequency by −3.03 (95% CI: −4.05, −2.00) as compared with Medicaid patients (p < 0.001) and was associated with a reduced frequency of prescription drugs used by −0.38 (95% CI: −0.67, −0.10, p < 0.01) after controlling for the other covariates. Conclusion Despite having comparable needs to Medicaid patients, uninsured patients with chronic conditions continue to have substantial unmet needs for health care services and limited access to the health care system. Health centres serve an important role in eliminating such disparity regardless of insurance status. In addition, Medicaid eligibility may also have a substantial and positive impact on improving health services utilization and access to care among these low-income patients.

Nonelective hospital admissions, discharge disposition, and health services utilization in epilepsy patients: A population‐based study

Epilepsia ◽  
2020 ◽  
Vol 61 (9) ◽  
pp. 1969-1978
Author(s):  
Churl‐Su Kwon ◽  
Bonnie Wong ◽  
Parul Agarwal ◽  
Jung‐Yi Lin ◽  
Madhu Mazumdar ◽  
...  
Keyword(s):  
Health Services ◽  
Hospital Admissions ◽  
Health Services Utilization ◽  
Population Based ◽  
Population Based Study ◽  
Services Utilization ◽  
Discharge Disposition

scholarly journals Does the implementation of a national oral health policy reduce inequalities in oral health services utilization? The Brazilian experience

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Helena Rodrigues Galvão ◽  
Angelo Giuseppe Roncalli
Keyword(s):  
Health Policy ◽  
Oral Health ◽  
Health Services ◽  
Health Services Utilization ◽  
Age Groups ◽  
Public Access ◽  
Services Utilization ◽  
Index Of Inequality ◽  
Oral Health Services ◽  
Oral Health Policy

Abstract Background This study aimed to assess the trend in income-related inequalities in oral health services utilization by the Brazilian population from 1998 to 2013. This period represents a timeline that includes different stages of implementation of the National Oral Health Policy. Methods The design was based on repeated cross-sectional surveys using secondary data from household-based studies carried out in Brazil in 1998, 2003, 2008, and 2013. The dependent variable was “having access to a dentist appointment at least once in a lifetime (yes/no).” Monthly household per capita income, based on Brazil’s minimum wage, was included as the main independent variable. To measure the inequalities in oral health access related to economic position, the following complex indexes based on regression were used: (a) the slope index of inequality (SII) and (b) the relative index of inequality (RII). Results There was a reduction in the percentage of individuals who never had a dentist appointment for all age groups and income classifications. In general, there was a reduction trend in absolute inequality for all age groups (p < 0.001). The relative inequality and reduction trend were different between the age groups studied. Conclusions The National Oral Health Policy was very important for expanding free of charge, public access to dental appointment. However, despite policy implementation, there continues to be high levels of inequality in access to dental consultation. Assessing which strategies are necessary to overcome this challenge is discussed.

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