title: Full-service family practice in British Columbia: policy interventions and trends in practice, 1991-2010.
abstract: BACKGROUND
  British Columbia's primary care reform (initiated in 2002) aims to promote "full-service family practice" through incentive payments and other practice support programs. Despite attention to policy, no longitudinal analysis has been conducted of the activities of BC primary care physicians.
  
  
  METHODS
  This study employed linked administrative health data from 1991/92 through 2009/10 to describe dimensions of care from the definition of "full-service family practice" used in BC reform, grouped into four categories: access, continuity, coordination and comprehensiveness.
  
  
  RESULTS
  Access, continuity and coordination of care fell over the study period (p < 0.001). Some dimensions reflecting comprehensiveness of care declined (obstetrics and geriatric care), though the remainder did not change significantly. Overall declining trends were consistent across physician characteristics and remained significant when accounting for shifts to non- fee-for-service payment.
  
  
  CONCLUSIONS
  Findings suggest efforts are not achieving their intended aims. Rigorous evaluation of individual components of reform is needed.
authors: Graduate Student, Centre for Health Services and Policy Research School of Population and Public Health Faculty of Medicine University of British Columbia Vancouver, BC.
authors: M Ruth
authors: MR
authors: Lavergne
authors: Analyst, Centre for Health Services and Policy Research University of British Columbia Vancouver, BC.
authors: Sandra
authors: S
authors: Peterson
authors: Research Coordinator, Centre for Health Services and Policy Research University of British Columbia Vancouver, BC.
authors: Rachael
authors: R
authors: McKendry
authors: Graduate Student, Centre for Health Services and Policy Research University of British Columbia Vancouver, BC.
authors: Saskia
authors: S
authors: Sivananthan
authors: Associate Professor, Centre for Health Services and Policy Research University of British Columbia Vancouver, BC.
authors: Kimberlyn
authors: K
authors: McGrail
mesh_terms: D000328:Adult; D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D018166:Health Care Reform; D006291:Health Policy; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000706:statistics & numerical data