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

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• 作者：Shammima Jesmin^a ; ^{shjesmin@gmail.com} ; Amardeep Thind^a ; ^b ; ^{athind2@uwo.ca} ; Sisira Sarma^a ; ^{ssarma2@uwo.ca}
• 关键词：Primary care ; Team ; Self-reported outcome ; Canada
• 刊名：Health Policy
• 出版年：2012
• 期刊代码：110_01688510
• 类别：med
• 出版时间：April, 2012
• 卷：105
• 期：1
• 页码：71-83
• 文件大小：326 K

摘要

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鈥?perception of several process and outcome indicators from patients鈥?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鈥?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.