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Research ArticleOriginal Research

Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study

Alan Katz, Nicole Herpai, Glenys Smith, Kris Aubrey-Bassler, Mylaine Breton, Antoine Boivin, William Hogg, Baukje Miedema, Jocelyn Pang, Walter P. Wodchis and Sabrina T. Wong
The Annals of Family Medicine May 2017, 15 (3) 230-236; DOI: https://doi.org/10.1370/afm.2059
Alan Katz
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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  • For correspondence: alan_katz@cpe.umanitoba.ca
Nicole Herpai
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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Glenys Smith
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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Kris Aubrey-Bassler
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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Mylaine Breton
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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Antoine Boivin
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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William Hogg
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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Baukje Miedema
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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Jocelyn Pang
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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Walter P. Wodchis
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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Sabrina T. Wong
Manitoba Centre for Health Policy, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Katz); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Herpai); The Ottawa Hospital Research Institute, Ottawa, Canada (Smith); Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada (Aubrey-Bassler); Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada (Breton); Department of Family Medicine, Université de Montréal Hospital Research Centre, Montreal, Quebec, Canada (Boivin); Bruyere Research Institute, Institute for Clinical Evaluative Sciences, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (Hogg); Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada (Miedema); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Pang, Wodchis); Institute for Clinical Evaluative Sciences, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada (Wodchis); Centre for Health Services and Policy Research and School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada (Wong).
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    Figure 1

    Average crude patient medical home scores in the Canadian provinces.

    AB = Alberta; BC = British Columbia; MB = Manitoba; NB = New Brunswick; NL = Newfoundland/Labrador;

    NS = Nova Scotia; O = Ontario; QC = Quebec; PEI = Prince Edward Island; SK = Saskatchewan.

    Note: Error bars represent 95% confidence intervals.

    aDenotes a significant difference (P <.05) from the national average.

Tables

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    • View popup
    Table 1

    The 10 Goals of the Patient Medical Home Model

      1. Patient centeredProvide services that are responsive to patients’ and their families’ feelings, preferences, and expectations
      2. Personal family physicianThe most responsible provider of a given patient’s medical care
    Every person in Canada should have a personal family physician
      3. Team-based careOffer a broad scope of services carried out by teams or networks of clinicians; inclusive of nurses, peer physicians, and others
      4. Timely accessTimely access to appointments in the practice
    Advocate for and coordinate timely appointments with other health and medical services required
      5. Comprehensive careProvide a comprehensive scope of family practice services by working collaboratively with other professionals
    Address public health needs
    Taking population health effects into account
      6. ContinuityOffer continuous care over time and in different settings
    Advocate on the patients’ behalf for continuity of care throughout the health care system
    Preserve constant relationships and continuous medical information for patients
      7. Electronic records and health informationMaintain electronic medical records
      8. Education, training, and researchServe as a model place for training students, residents, and other health professionals
    Carry out and/or encourage staff to be involved in primary care research
      9. EvaluationCarry out ongoing evaluation as part of the commitment to continuous quality improvement
    10. System supportInternal support through governance and management structures
    External support by stakeholders, the public, and other medical and health professionals and their organizations across Canada
    • View popup
    Table 2

    Practice Characteristics Included in the Statistical Model

    No. (%)
    Community size
     Large city center238 (30.36)
     Suburbs133 (16.96)
      (Small) town152 (19.39)
     Mixed urban-rural107 (13.65)
     Rural154 (19.64)
    Funding model
     New model of primary care with special funding421 (53.16)
     Traditional model371 (46.84)
    Practice population size
     ≤800185 (23.36)
     801–1600310 (39.14)
     1,601–2,400162 (20.45)
     2,401–3,20071 (8.96)
     >3,20064 (8.08)
    Wait time between scheduled appointment and consultation
     <15 min3,592 (50.08)
     15–30 min2,074 (28.92)
     31–45 min630 (8.78)
     >46 min481 (6.70)
    Hours of operation
     Clearly indicated outside office entrance480 (62.18)
     Not clearly indicated276 (35.75)
    How to get care outside of office hours
     Clearly indicated outside office entrance216 (27.98)
     Not clearly indicated526 (68.13)
    Parking for people with disabilities
     Yes684 (88.6)
     No81 (10.49)
    Physical accessibility of practice
     Ground floor477 (61.79)
     Elevator255 (33.03)
     No elevator/not ground floor35 (4.53)
    Physical access for patients with a wheelchair or stroller
     Very easy453 (58.68)
     Easy273 (35.36)
     Difficult/Impossible to access46 (5.96)
    Accessible toilet for patients with disabilities
     Yes672 (87.05)
     No87 (11.27)
    • Note: All practice characteristics were included in the model regardless of their significance (P <.05). Practice characteristics related to physical accessibility (last 6 characteristics above) were combined into 1 variable, “superior access.” The reference category for practice population size was 801–1600, as this response was most common. For wait time, we calculated each practice’s average wait time. Québec was chosen as a reference category for province because it represented the largest sample.

    • View popup
    Table 3

    QUALICO-PC Surveys Undertaken in Each Province

    ProvinceFamily Physician No.Practice No.Patient Experience No.Total by Province No.Completion Rate %
    Ontario1841831,6982,06581
    British Columbia595853765484
    Newfoundland and Labrador414132040257
    Alberta1161171,2401,47370
    New Brunswick/PEI545349760470
    Saskatchewan202018522577
    Nova Scotia595854466175
    Manitoba412435341867
    Québec2182181,7982,23484
    Total surveys by type7927727,172
    • PEI = Prince Edward Island; QUALICO-PC = Quality and Costs of Primary Care.

    • Note: Completion rates calculated as the number of physicians who completed the survey package divided by the number of physicians who received the survey package.

    • View popup
    Table 4

    Adjusted Mean Differences in Patient Medical Home Scores Among Canadian Provinces, Using Québec as the Reference Province

    Patient Medical Home GoalMean Differences (95% CI)Mean Differences (95% CI)
    OntarioBritish ColumbiaNewfoundland/LabradorAlbertaNew Brunswick/Prince Edward IslandSaskatchewanNova ScotiaManitoba
    Patient medical home (overall)1.48 (1.33 to 1.63)a0.84 (0.62 to 1.05)a0.01 (−0.23 to 0.26)0.63 (0.46 to 0.80)a0.10 (−0.13 to 0.32)0.39 (0.04 to 0.74)a0.78 (0.56 to 0.99)a0.50 (0.25 to 0.75)a
    Patient centered1.03 (0.31 to 1.75)a0.90 (−0.16 to 1.95)0.52 (−0.71 to 1.74)1.64 (−2.43 to −0.84)a0.46 (−0.63 to 1.54)0.69 (−0.99 to 2.37)0.78 (−0.27 to 1.83)−0.54 (−1.76 to 0.69)
    Personal family physician2.37 (1.53 to 3.20)a2.31 (1.08 to 3.54)a1.26 (−0.17 to 2.68)−0.71 (−1.64 to 0.21)1.16 (−0.10 to 2.42)1.58 (−0.37 to 3.54)1.67 (0.45 to 2.89)a1.73 (0.31 to 3.15)a
    Team-based care−0.34 (−1.20 to 0.51)−0.96 (−2.22 to 0.29)−0.79 (−2.25 to 0.66)−2.44 (−3.38 to −1.49)a−0.04 (−1.33 to 1.25)−1.60 (−3.60 to 0.39)−0.40 (−1.64 to 0.85−4.88 (−6.34 to −3.43)a
    Timely access1.69 (1.10 to 2.28)a0.39 (−0.48 to 1.26)−0.19 (−1.20 to 0.82)−0.59 (−1.24 to 0.07)−1.40 (−2.29 to −0.51)a−0.06 (−1.44 to 1.32)0.02 (−0.84 to 0.88)−1.07 (−2.08 to −0.07)a
    Comprehensive care3.88 (2.06 to 5.69)a7.42 (4.75 to 10.09)a6.34 (3.25 to 9.44)a−2.36 (−4.37 to −0.35)a1.88 (−0.86 to 4.63)6.92 (2.67 to 11.17)a4.01 (1.36 to 6.66)a1.87 (−1.22 to 4.97)
    Continuity1.14 (0.83 to 1.45)a1.56 (1.10 to 2.01)a0.72 (0.19 to 1.24)a0.66 (0.32 to 1.00)a0.98 (0.51 to 1.45)a0.88 (0.16 to 1.60)a1.29 (0.84 to 1.75)a1.05 (0.52 to 1.57)a
    Electronic records and health information2.73 (2.34 to 3.13)a2.28 (1.70 to 2.86)a0.07 (−0.61 to 0.74)2.32 (1.87 to 2.78)a−0.30 (−0.90 to 0.30)1.63 (0.70 to 2.55)a1.79 (1.21 to 2.37)a2.75 (2.08 to 3.42)a
    Education, training, and research−0.18 (−0.75 to 0.40)−0.08 (−0.92 to 0.75)−0.59 (−1.57 to 0.39)−0.21 (−0.86 to 0.45)−0.44 (−1.31 to 0.42)0.23 (−1.10 to 1.56)0.05 (−0.79 to 0.89)0.01 (−0.96 to 0.98)
    Evaluation2.22 (1.89 to 2.56)a1.56 (1.07 to 2.05)a−0.22 (−0.80 to 0.35)1.16 (0.78 to 1.55)a0.22 (−0.29 to 0.73)0.47 (−0.32 to 1.25)1.31 (0.81 to 1.80)a1.73 (1.16 to 2.30)a
    • Note: Estimates are adjusted for variables shown in Table 2.

    • ↵a Values are significantly different (P <.05) from the reference province (Québec).

Additional Files

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  • The Article in Brief

    Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study

    Alan Katz , and colleagues

    Background Canada's patient medical home (PMH) model includes ten goals that enable the best possible health outcomes for patients and communities, while emphasizing Canadian health care values. This study aims to determine to what extent the structure and processes that define primary care in Canada align with PMH model goals.

    What This Study Found Evaluating the degree to which primary care across Canada comports with the goals of the Patient Medical Home model, researchers find considerable room for improvement. Ten measurable indicators of the PMH model were applied across all 10 Canadian provinces. The results indicated an average national PMH composite score of 5.36 out of 10. Ontario was the only province to score significantly higher than Canada as a whole, while Quebec, Newfoundland/Labrador, and New Brunswick/Prince Edward Island scored below the national average. There was little variation among provinces in achieving the 10 PMH goals. Although the PMH is a pan-Canadian model, implementation is dependent on provincial and regional or local policies, and during the past 15 years, new primary care funding models have been introduced without consistency in timing, key model components or implementation strategies across provinces.

    Implications

    • The authors call for future research into the effects of reform on practice characteristics and processes, and assessment of health services utilization and quality measures for clinical conditions. The information gained from these activities, they posit, may motivate further uptake of the PMH model's attributes in all provinces
  • Supplemental Appendixes

    Supplemental Appendixes

    Files in this Data Supplement:

    • Supplemental data: Appendixes - PDF file
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The Annals of Family Medicine: 15 (3)
The Annals of Family Medicine: 15 (3)
Vol. 15, Issue 3
May/June 2017
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Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study
Alan Katz, Nicole Herpai, Glenys Smith, Kris Aubrey-Bassler, Mylaine Breton, Antoine Boivin, William Hogg, Baukje Miedema, Jocelyn Pang, Walter P. Wodchis, Sabrina T. Wong
The Annals of Family Medicine May 2017, 15 (3) 230-236; DOI: 10.1370/afm.2059

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Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study
Alan Katz, Nicole Herpai, Glenys Smith, Kris Aubrey-Bassler, Mylaine Breton, Antoine Boivin, William Hogg, Baukje Miedema, Jocelyn Pang, Walter P. Wodchis, Sabrina T. Wong
The Annals of Family Medicine May 2017, 15 (3) 230-236; DOI: 10.1370/afm.2059
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