Primary Health Care Teams and their Impact on Processes and Outcomes of Care

By: Saeeda Khan, Cameron McIntosh, Claudia Sanmartin, Diane Watson, Kira Leeb

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Executive summary

Canadians look to primary health care providers for many of their basic health care needs, as well as for management of most chronic conditions.  In 2000, the First Ministers agreed to promote the establishment of primary health care teams that would focus on health promotion, disease prevention, and chronic diseases.  In the 2004, they strengthened their commitment with the objective that half of Canadians would have access to multidisciplinary teams by 2011.  Considerable investments have been made over the past decade in an effort to meet these goals. 

The purpose of this study was to assess the degree to which Canadians have access to primary health care teams (Project 1) and the impact of those teams on processes of care and on outcomes (Projects 2 and 3). The study is based on data from the Canadian Survey of Experiences with Primary Health Care (CSE-PHC), the first national survey of primary care.  The survey was sponsored by the Health Council of Canada and conducted by Statistics Canada.

The key results are:

• Almost 40% of Canadians have access to a primary health care team, defined as access to a nurse or other health professional (for example, dietitian, nutritionist) or both at their medical doctor or regular place of care.
• Individuals with two or more chronic conditions and those reporting "fair/poor" health were more likely than people in better health to report access to a primary health care team.
• Those who have access to a primary health care team are more likely to receive health promotion and disease prevention, particularly those who have chronic conditions.
• People with chronic conditions who have team-based care are more likely than those who do not to receive whole-person care and higher levels of care coordination.  They are also more likely to report receiving a higher quality of health care.
• Access to primary health care teams reduces emergency room use through reductions in unmet needs and in uncoordinated care.  Reductions in uncoordinated care also lessen the risk of hospitalization.   
• Reductions in unmet needs and uncoordinated care, and the more positive ratings of quality of health care in general, indirectly enhance confidence in the health care system. 
• However, access to teams may have a negative direct effect on confidence when experiences with those teams do not result in improved processes of care.

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