Does team-based primary health care improve patients' perception of outcomes? Evidence from the 2007-08 Canadian Survey of Experiences with Primary Health.
BACKGROUND
Team-based practice in primary care has been advocated for improved access, quality, effectiveness, and cost-efficiency of primary health care services, but there is limited empirical evidence supporting it.


OBJECTIVE
To examine the impact of team-based practice on patients' perception of several process and outcome indicators from patients' perspective.


METHODS
Micro data from the 2007-08 Canadian Survey of Experiences with Primary Health Care conducted by Statistics Canada were utilized. Regression techniques and propensity score matching method were used to examine the impact of team-based primary care on several process and outcome indicators of primary care.


RESULTS
The estimated average treatment effect of team-based care was positively significant and robust for access to after-hours care, quality of care, confidence in the system, overall coordination of care, and patient centeredness. Although the estimated average treatment effects for the two dimensions of follow-up coordination, continuity of care, health promotion and disease prevention initiatives, and utilization of physician and nurse services were statistically significant, sensitivity test results showed that these results were unreliable.


CONCLUSIONS
Team-based primary care improves patients' perception of process and outcome indicators in the area of access to after-hours care, quality of care, confidence in the system, overall coordination and patient centeredness. Future research needs to establish the causal link between team-based primary care and health outcomes of patients.
Department of Epidemiology and Biostatistics, University of Western Ontario, Canada. shjesmin@gmail.com
Shammima
S
Jesmin
Amardeep
A
Thind
Sisira
S
Sarma
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002170:Canada; D003266:Continuity of Patient Care / Q000458:organization & administration / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D019984:Quality Indicators, Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult