Does team-based primary health care improve patients' perception of outcomes? Evidence from the 2007-08 Canadian Survey of Experiences with Primary Health

Health Policy. 2012 Apr;105(1):71-83. doi: 10.1016/j.healthpol.2012.01.008. Epub 2012 Feb 10.

Abstract

Background: Team-based practice in primary care has been advocated for improved access, quality, effectiveness, and cost-efficiency of primary health care services, but there is limited empirical evidence supporting it.

Objective: To examine the impact of team-based practice on patients' perception of several process and outcome indicators from patients' perspective.

Data and methods: Micro data from the 2007-08 Canadian Survey of Experiences with Primary Health Care conducted by Statistics Canada were utilized. Regression techniques and propensity score matching method were used to examine the impact of team-based primary care on several process and outcome indicators of primary care.

Results: The estimated average treatment effect of team-based care was positively significant and robust for access to after-hours care, quality of care, confidence in the system, overall coordination of care, and patient centeredness. Although the estimated average treatment effects for the two dimensions of follow-up coordination, continuity of care, health promotion and disease prevention initiatives, and utilization of physician and nurse services were statistically significant, sensitivity test results showed that these results were unreliable.

Conclusions: Team-based primary care improves patients' perception of process and outcome indicators in the area of access to after-hours care, quality of care, confidence in the system, overall coordination and patient centeredness. Future research needs to establish the causal link between team-based primary care and health outcomes of patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Canada
  • Continuity of Patient Care / organization & administration
  • Continuity of Patient Care / statistics & numerical data
  • Cost-Benefit Analysis / organization & administration
  • Cost-Benefit Analysis / statistics & numerical data
  • Female
  • Health Care Surveys
  • Health Services Accessibility / organization & administration
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team / organization & administration*
  • Patient Care Team / standards
  • Patient Satisfaction*
  • Primary Health Care / organization & administration*
  • Primary Health Care / standards
  • Quality Indicators, Health Care / organization & administration
  • Quality Indicators, Health Care / statistics & numerical data
  • Quality of Health Care / organization & administration
  • Quality of Health Care / statistics & numerical data
  • Sex Factors
  • Treatment Outcome
  • Young Adult