Back to Search
Start Over
Primary care reform and service use by people with serious mental illness in Ontario.
- Source :
-
Healthcare policy = Politiques de sante [Healthc Policy] 2014; Vol. 10 (1), pp. 31-45. - Publication Year :
- 2014
-
Abstract
- Purpose: To examine service use by adults with serious mental illness (SMI) rostered in new primary care models: enhanced fee-for-service (FFS), blended-capitation (CAP) and team-based capitation (TBC) models with and without mental health workers (MHW) in Ontario.<br />Methods: This cross-sectional study used administrative health service databases to compare use of mental health and general health services among persons with SMI enrolled in new models (n = 125,233).<br />Results: Relative to persons rostered in enhanced FFS, those in CAP and TBC had fewer mental health primary care visits (adjusted rate ratios and 95% confidence limits: CAP: 0.77 [0.74, 0.81]; TBC with MHW: 0.72 [0.68, 0.76]; TBC with no MHW: 0.81 [0.72, 0.93]). Compared to patients in enhanced FFS, those in TBC models also had more mental health hospital admissions (TBC with MHW: 1.12 [1.05, 1.20]; TBC with no MHW: 1.22 [1.05, 1.41]). Patterns of use of general services were similar.<br />Conclusion: Further attention to financial incentives in capitation that influence care of persons with SMI is necessary to determine if they are aligned with aims of primary care reform.<br /> (Copyright © 2014 Longwoods Publishing.)
Details
- Language :
- English
- ISSN :
- 1715-6580
- Volume :
- 10
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Healthcare policy = Politiques de sante
- Publication Type :
- Academic Journal
- Accession number :
- 25410694