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

被引:41
作者
Jesmin, Shammima
Thinda, Amardeep [2 ]
Sarma, Sisira [1 ]
机构
[1] Univ Western Ontario, Dept Epidemiol & Biostat, Schulich Sch Med & Dent, London, ON N6A 5C1, Canada
[2] Univ Western Ontario, Ctr Studies Family Med, London, ON N6A 5C1, Canada
关键词
Primary care; Team; Self-reported outcome; Canada; CENTERED MEDICAL HOME; GENERAL-PRACTITIONERS; QUALITY; SATISFACTION; TRIAL; ORGANIZATIONS; CONTINUITY; EDUCATION; SERVICES; ACCESS;
D O I
10.1016/j.healthpol.2012.01.008
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
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' 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. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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页码:71 / 83
页数:13
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