Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
ICES, Toronto, Ontario, Canada.
Health Econ. 2024 Oct;33(10):2288-2305. doi: 10.1002/hec.4872. Epub 2024 Jun 19.
Improving access to primary care physicians' services may help reduce hospitalizations due to Ambulatory Care Sensitive Conditions (ACSCs). Ontario, Canada's most populous province, introduced blended payment models for primary care physicians in the early- to mid-2000s to increase access to primary care, preventive care, and better chronic disease management. We study the impact of payment models on avoidable hospitalizations due to two incentivized ACSCs (diabetes and congestive heart failure) and two non-incentivized ACSCs (angina and asthma). The data for our study came from health administrative data on practicing primary care physicians in Ontario between 2006 and 2015. We employ a two-stage estimation strategy on a balanced panel of 3710 primary care physicians (1158 blended-fee-for-service (FFS), 1388 blended-capitation models, and 1164 interprofessional team-based practices). First, we account for the differences in physician practices using a generalized propensity score based on a multinomial logit regression model, corresponding to three primary care payment models. Second, we use fractional regression models to estimate the average treatment effects on the treated outcome (i.e., avoidable hospitalizations). The capitation-based model sometimes increases avoidable hospitalizations due to angina (by 7 per 100,000 patients) and congestive heart failure (40 per 100,000) relative to the blended-FFS-based model. Switching capitation physicians into interprofessional teams mitigates this effect, reducing avoidable hospitalizations from congestive heart failure by 30 per 100,000 patients and suggesting better access to primary care and chronic disease management in team-based practices.
改善初级保健医生服务的可及性可能有助于减少因门诊医疗敏感条件(ACSCs)而导致的住院治疗。加拿大人口最多的安大略省在 21 世纪初至中期为初级保健医生引入了混合支付模式,以增加初级保健、预防保健和更好的慢性病管理。我们研究了支付模式对因两个激励性 ACSC(糖尿病和充血性心力衰竭)和两个非激励性 ACSC(心绞痛和哮喘)而导致的可避免住院的影响。我们的研究数据来自安大略省 2006 年至 2015 年期间执业初级保健医生的健康管理数据。我们在一个平衡面板(3710 名初级保健医生)上采用两阶段估计策略,包括 1158 名混合费用-服务(FFS)、1388 名混合按人头付费模型和 1164 名跨专业团队实践。首先,我们使用基于多项逻辑回归模型的广义倾向得分来考虑医生实践的差异,对应于三种初级保健支付模式。其次,我们使用分数回归模型来估计对治疗结果(即可避免的住院治疗)的平均治疗效果。与基于混合 FFS 的模型相比,基于人头付费的模型有时会增加因心绞痛(每 10 万人增加 7 例)和充血性心力衰竭(每 10 万人增加 40 例)而导致的可避免住院治疗。将人头付费医生转换为跨专业团队可以减轻这种影响,使充血性心力衰竭的可避免住院治疗减少 30 例/每 10 万人,并表明基于团队的实践中可以更好地获得初级保健和慢性病管理。