Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study

Affiliations

¹ Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong). alan_katz@cpe.umanitoba.ca.
² Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).

PMID: 28483888
PMCID: PMC5422084
DOI: 10.1370/afm.2059

Comparative Study

Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study

Alan Katz et al. Ann Fam Med. 2017 May.

. 2017 May;15(3):230-236.

doi: 10.1370/afm.2059.

Authors

Affiliations

¹ Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong). alan_katz@cpe.umanitoba.ca.
² Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).

PMID: 28483888
PMCID: PMC5422084
DOI: 10.1370/afm.2059

Abstract

Purpose: The patient medical home (PMH) model aims to improve patient satisfaction and health outcomes in Canada, but since its introduction in 2009, there has been no evaluation of the extent to which primary care conforms with PMH attributes. Our objective was to compare current primary care across Canada with the 10 goals of the PMH model.

Methods: A cross-sectional survey of primary care organization and delivery was conducted in Canadian provinces to evaluate the PMH-based attributes of primary care practices. Family physician and patient responses were mapped to the 10 goals of the PMH model. We used regression models to describe the provinces' success in meeting the goals, taking specific practice characteristics into account. We created a PMH composite score by weighting each goal equally for each practice and aggregating these by province. The PMH score is the sum of the values for each goal, which were scored from 0 to 1; a score of 10 indicates that all 10 goals of the PMH model were achieved.

Results: Seven hundred seventy-two primary care practices and 7,172 patients participated in the survey. The average national PMH score was 5.36 (range 4.75-6.23) of 10. Ontario was the only province to score significantly higher than Canada as a whole, whereas Québec, Newfoundland/Labrador, and New Brunswick/Prince Edward Island scored below the national average. There was little variation, however, among provinces in achieving the 10 PMH goals.

Conclusions: Provincial PMH scores indicate considerable room for improvement if the PMH goals are to be fully implemented in Canada.

Keywords: Canada; patient medical home; patient-centered care; primary care.

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Figures

**Figure 1**
Average crude patient medical home scores in the Canadian provinces. AB = Alberta; BC = British Columbia; MB = Manitoba; NB = New Brunswick; NL = Newfoundland/Labrador; NS = Nova Scotia; O = Ontario; QC = Quebec; PEI = Prince Edward Island; SK = Saskatchewan. Note: Error bars represent 95% confidence intervals. ^aDenotes a significant difference (P <.05) from the national average.

See this image and copyright information in PMC

References

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Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study

Affiliations

Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

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