Primary care reform in Alberta: Costs for family physicians and expanded roles of independent nurse practitioners.

OBJECTIVE

To analyze the economic effects of policies created by the Alberta government to address the shortage of family physician (FP) services following the COVID-19 pandemic.

DESIGN

Starting with the government's statement of the shortage (between 600,000 and 700,000 persons with unmet primary care needs) and using current caseload measures, a measure of the number of FPs and nurse practitioners (NPs) needed to fill the gap was developed.

SETTING

Alberta.

PARTICIPANTS

FPs and NPs.

MAIN OUTCOME MEASURES

The cost of meeting unmet needs based on provincial payment data.

RESULTS

The government set 2 priorities to meet the shortage: to increase the number of FPs and to establish and implement a framework for NPs as independent primary care practitioners. Based on the defined shortage and excluding population growth, an estimated need was calculated: 715 additional FPs with 100% coverage, or 715 additional NPs covering 80% of the needed services (893 added NP-equivalents). The cost of each alternative was calculated as $245.9 million for FPs and $176.3 million for NPs. The time needed to achieve either of these alternatives is more than a decade.

CONCLUSION

The time to address the current doctor shortage is substantial and needs to be factored into government primary care policies.