title: Patient poverty and workload in primary care: study of prescription drug benefit recipients in community health centres.
abstract: OBJECTIVE
  To determine if patient poverty is associated with increased workload for primary care providers (PCPs).
  
  
  METHODS
  Linkage of administrative data identifying patient poverty and comorbidity with survey data about the organizational structure of community health centres (CHCs).
  
  
  METHODS
  Ontario's 73 CHCs.
  
  
  METHODS
  A total of 64 CHC sites (N=63 included in the analysis).
  
  
  METHODS
  Patient poverty was determined in 2 different ways: based on receipt of Ontario Drug Benefits (identifying recipients of welfare, provincial disability support, and low-income seniors' benefits) or residence in low-income neighbourhoods. Patient comorbidities were determined through administrative diagnostic data from the CHCs and the Institute for Clinical Evaluative Sciences. Primary care workload was determined by examining PCP panel size (the number of patients cared for by a full-time-equivalent PCP during a 2-year interval).
  
  
  RESULTS
  The CHCs with higher proportions of poor patients had smaller panel sizes. The smaller panel sizes were entirely explained by the medical comorbidity profile of the poor patients.
  
  
  CONCLUSIONS
  Poor patients generate a higher workload for PCPs in CHCs; however, this is principally because they are sicker than higher-income patients are. Further information is required about the spectrum of services used by poor patients in CHCs.
authors.affiliation: C.T. Lamont Primary Health Care Research Centre, the Bruyère Research Institute, Ottawa, ON K1R 6S3. lmuldoon@swchc.on.ca
authors.forename: Laura
authors.initials: L
authors.lastname: Muldoon
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rayner
authors.forename: Simone
authors.initials: S
authors.lastname: Dahrouge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003151:Community Health Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011204:Poverty Areas; D011320:Primary Health Care / Q000706:statistics & numerical data*; D000078329:Workforce; D016526:Workload / Q000706:statistics & numerical data*; D055815:Young Adult