Efficiency of Ontario primary care physicians across payment models: a stochastic frontier analysis.
OBJECTIVE
The study examines the relationship between the primary care model that a physician belongs to and the efficiency of the primary care physician in Ontario, Canada.


METHODS
Survey data were collected from 183 self-selected physicians and linked to administrative databases to capture the provision of services to the patients served for the 12 month period ending June 30, 2013, and the characteristics of the patients at the beginning of the study period. Two stochastic frontier regression models were used to estimate efficiency scores and parameters for two separate outputs: the number of distinct patients seen and the number of visits.


RESULTS
Because of missing data, only 165 physicians were included in the analyses. The average efficiency was 0.72 for both outputs with scores varying from 4 % to 93 % for the visits and 5 % to 94 % for the number of patients seen. We observed that there were both very low and very high efficiency scores within each model. These variations were larger than variations in average scores across models.
Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, 1225 Center Dr, Room 3111, Gainesville, FL, 32610, USA. maude.laberge@phhp.ufl.edu.|Canadian Centre for Health Economics, Toronto, Canada. maude.laberge@phhp.ufl.edu.
Maude
M
Laberge
Canadian Centre for Health Economics, Toronto, Canada.|Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.|Institute for Clinical Evaluative Sciences, Toronto, Canada.|Toronto Rehabilitation Institute, Toronto, Canada.
Walter P
WP
Wodchis
Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.|Institute for Clinical Evaluative Sciences, Toronto, Canada.
Jan
J
Barnsley
Canadian Centre for Health Economics, Toronto, Canada.|Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
Audrey
A
Laporte
Efficiency; Frontier analysis; Physician remuneration; Primary care; Productivity