title: Increasing value for money in the Canadian healthcare system: new findings on the contribution of primary care services.
abstract: This article presents a major new finding in regard to the value for money of primary care services. It was found that the more higher-care-needs patients were attached to a primary care practice, the lower the costs were for the overall healthcare system (for the total of medical services, hospital services and drugs). The majority of the cost reductions stemmed from decreases in the costs of hospital services. Thus, for higher-care-needs patients, it appears that the nature of the physician-patient relationship is related to reductions in hospital costs. For example, for very-high-care-needs diabetic patients, the average annual hospital cost in fiscal 2007-2008 for those in the lowest attachment group was $16,988, whereas the hospital costs for those in the highest attachment group was $5,909. The results obtained were even more striking for patients with congestive heart failure. A series of multiple regression analyses were conducted, and the results were very consistent: attachment to practice was the best predictor in regard to cost and was a more significant predictor than other variables that were related to healthcare costs, such as age. These findings support the general literature on the benefits of primary care and the continuity of care.
authors.affiliation: Hollander Analytical Services Ltd., Victoria, British Columbia. marcus@hollanderanalytical.com
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Hollander
authors.forename: Helena
authors.initials: H
authors.lastname: Kadlec
authors.forename: Ramsay
authors.initials: R
authors.lastname: Hamdi
authors.forename: Angela
authors.initials: A
authors.lastname: Tessaro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000191:economics; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000191:economics*; D003920:Diabetes Mellitus / Q000191:economics; D005260:Female; D006333:Heart Failure / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics*; D012196:Review Literature as Topic