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dc.contributor.author Katz, Alan
dc.contributor.author Martens, Patricia
dc.contributor.author Chateau, Dan
dc.contributor.author Bogdanovic, Bodgan
dc.contributor.author Koseva, Ina
dc.date.accessioned 2014-09-08T19:04:14Z
dc.date.available 2014-09-08T19:04:14Z
dc.date.issued 2014-08-30
dc.identifier.citation BMC Family Practice. 2014 Aug 30;15(1):148
dc.identifier.uri http://hdl.handle.net/1993/23994
dc.description.abstract Abstract Background Adults with chronic disease are the most frequent users of the primary healthcare system. In Manitoba, patients are allowed to seek ambulatory (outpatient) care from the provider of their choosing (primary care physician or specialist), with referrals to specialists preferred but not always required. Some patients receive their routine care from specialists. We conducted this study to determine the patterns by which adults with chronic disease access ambulatory care as a prelude to exploring the impact these patterns may have on the quality of care received. Methods Physician claims for all visits between 2007/8-2009/10 were extracted from the Data Repository at the Manitoba Centre for Health Policy. Patients included in the analysis made at least four ambulatory visits to a primary care physician or specialist within the study period, and met the definition criteria for at least one of six chronic diseases: diabetes mellitus; congestive heart failure; mood disorders; ischemic heart disease; total respiratory morbidity; and/or hypertension. Patients were “assigned” to the physician they visited most regularly. Physician visit patterns were assessed by dividing visits into nine visit types based on the type of physician patients visited (assigned primary care physician, other primary care physician, or specialist) and whether or not they received a referral. Results 347,606 patients with 7,662,411 physician visits were included in the analysis. Most visits were to the patients’ assigned primary care physician. About 50% of the visits to specialists were by referral from the assigned primary care physician. However, 26-29% of all visits to a primary care physician were not to the assigned primary care physician, and non-assigned physicians were more likely to refer patients to specialists than assigned primary care physicians. Conclusion The findings suggest that the current primary care system in Manitoba may not adequately support coordination of ambulatory care. Ambulatory visits to a primary care provider who is not the patient’s regular provider may represent a lost opportunity for coordination and continuity of care, and may affect the quality of care patients receive. Primary care renewal initiatives in this province should address this challenge to service provision.
dc.title Do primary care physicians coordinate ambulatory care for chronic disease patients in Canada?
dc.type Journal Article
dc.language.rfc3066 en
dc.description.version Peer Reviewed
dc.rights.holder Alan Katz et al.; licensee BioMed Central Ltd.
dc.date.updated 2014-09-08T19:04:15Z
dc.identifier.doi http://dx.doi.org/10.1186/1471-2296-15-148


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