Interprofessional team-based primary care practice and preventive cancer screening: evidence from Family Health Teams in Ontario, Canada

Abstract

Health care reforms introduced interprofessional team-based primary care to optimize access to health care and preventive services. In this context, preventive cancer screening represents an important measure as it is essential for the early detection of cancer and treatment. We investigated the effects of Family Health Teams (FHTs), an interprofessional team-based primary care practice setting, on cancer screening rates in Ontario, Canada. By utilizing comprehensive health administrative data from April 1st 2011 to March 31st 2023, we determined the effect of FHT on screening rates for breast, cervical, and colorectal cancer while controlling for relevant physician and patient characteristics. Our analytical framework employs fractional probit models, including the Mundlak procedure, and generalized estimating equations to assess the impact of practicing in FHTs on cancer screening rates, while accounting for unobserved physician heterogeneity. Our results indicate that compared to non-FHTs, physicians practicing in FHTs have higher breast (2.4%), cervical (2%), and colon (0.8%) cancer screening rates per physician per year. The effectiveness of FHTs in promoting cancer screenings is particularly pronounced in smaller practices and among populations in rural and economically deprived areas. Our findings highlight the role of teams in enhancing preventive health care services potentially through task shifting mechanisms and suggest that such models may offer a pathway to improving access to preventive health care, especially in marginalized populations. Our research contributes to the literature by providing empirical evidence on the benefits of interprofessional team-based primary care in improving cancer screening.

Keywords: Canada; Cancer screening; Family health team; Fractional probit; Team-based primary care.