Role of Interprofessional primary care teams in preventing avoidable hospitalizations and hospital readmissions in Ontar
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(2020) 20:782
RESEARCH ARTICLE
Open Access
Role of Interprofessional primary care teams in preventing avoidable hospitalizations and hospital readmissions in Ontario, Canada: a retrospective cohort study Wissam Haj-Ali1,2,3,4* , Rahim Moineddin1,2,4,5, Brian Hutchison6, Walter P. Wodchis1,2,4,7 and Richard H. Glazier1,2,4,5,8
Abstract Background: Improving 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 noninterprofessional primary care teams and ambulatory care sensitive condition (ACSC) hospitalizations and hospital readmissions. Methods: Population-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. Results: As 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. (Continued on next page)
* Correspondence: [email protected] 1 Dalla Lana School of Public Health, Toronto, Ontario, Canada 2 Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and t
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