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Research ArticleOriginal Research

Health Care Utilization After a Visit to a Within-Group Family Physician vs a Walk-In Clinic Physician

Christine Salahub, Peter C. Austin, Li Bai, Simon Berthelot, R. Sacha Bhatia, Cherryl Bird, Laura Desveaux, Tara Kiran, Aisha Lofters, Danielle Martin, Kerry McBrien, Rita K. McCracken, J. Michael Paterson, Bahram Rahman, Jennifer Shuldiner, Mina Tadrous, Niels Thakkar, Noah M. Ivers and Lauren Lapointe-Shaw
The Annals of Family Medicine November 2024, 22 (6) 483-491; DOI: https://doi.org/10.1370/afm.3181
Christine Salahub
1Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada (Salahub)
PhD
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Peter C. Austin
2ICES, Toronto, Ontario, Canada (Austin, Bai, Kiran, Paterson, Tadrous, Ivers, Lapointe-Shaw)
3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Austin, Desveaux, Kiran, Martin, Paterson, Ivers, Lapointe-Shaw)
4Sunnybrook Research Institute, Toronto, Ontario, Canada (Austin)
PhD
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Li Bai
2ICES, Toronto, Ontario, Canada (Austin, Bai, Kiran, Paterson, Tadrous, Ivers, Lapointe-Shaw)
PhD
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Simon Berthelot
5Département de médecine de famille et de médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada (Berthelot)
MD, MSc
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R. Sacha Bhatia
6Department of Medicine, University of Toronto, Toronto, Ontario, Canada (Bhatia, Lapointe-Shaw)
7Department of Cardiology, University Health Network, Toronto, Ontario, Canada (Bhatia)
MD, MBA
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Cherryl Bird
8Patient Partner, University Health Network, Toronto, Ontario, Canada (Bird)
HBA
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Laura Desveaux
3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Austin, Desveaux, Kiran, Martin, Paterson, Ivers, Lapointe-Shaw)
9Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada (Desveaux, Shuldiner, Tadrous, Ivers, Lapointe-Shaw)
10Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada (Desveaux)
PhD, MScPT
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Tara Kiran
2ICES, Toronto, Ontario, Canada (Austin, Bai, Kiran, Paterson, Tadrous, Ivers, Lapointe-Shaw)
3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Austin, Desveaux, Kiran, Martin, Paterson, Ivers, Lapointe-Shaw)
11Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada (Kiran, Lofters, Martin, Ivers)
12MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada (Kiran);
13Department of Family and Community Medicine, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada (Kiran)
MD, MSc
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Aisha Lofters
11Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada (Kiran, Lofters, Martin, Ivers)
14Peter Gilgan Centre for Women’s Cancers, Women’s College Hospital, Toronto, Ontario, Canada (Lofters)
MD, PhD
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Danielle Martin
3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Austin, Desveaux, Kiran, Martin, Paterson, Ivers, Lapointe-Shaw)
11Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada (Kiran, Lofters, Martin, Ivers)
15Department of Family Medicine, Women’s College Hospital, Toronto, Ontario, Canada (Martin, Ivers)
MD, MPP
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Kerry McBrien
16Departments of Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (McBrien)
MD, MPH
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Rita K. McCracken
17Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada (McCracken)
MD, PhD
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J. Michael Paterson
2ICES, Toronto, Ontario, Canada (Austin, Bai, Kiran, Paterson, Tadrous, Ivers, Lapointe-Shaw)
3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Austin, Desveaux, Kiran, Martin, Paterson, Ivers, Lapointe-Shaw)
MSc
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Bahram Rahman
18Primary Health Care Branch, Ministry of Health, Ontario, Canada (Rahman)
19Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada (Rahman)
MD, MPP
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Jennifer Shuldiner
9Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada (Desveaux, Shuldiner, Tadrous, Ivers, Lapointe-Shaw)
MPH, PhD
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Mina Tadrous
2ICES, Toronto, Ontario, Canada (Austin, Bai, Kiran, Paterson, Tadrous, Ivers, Lapointe-Shaw)
9Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada (Desveaux, Shuldiner, Tadrous, Ivers, Lapointe-Shaw)
20Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada (Tadrous);
PharmD, PhD
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Niels Thakkar
21College of Nurses of Ontario, Toronto, Ontario, Canada (Thakkar)
MSc
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Noah M. Ivers
2ICES, Toronto, Ontario, Canada (Austin, Bai, Kiran, Paterson, Tadrous, Ivers, Lapointe-Shaw)
3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Austin, Desveaux, Kiran, Martin, Paterson, Ivers, Lapointe-Shaw)
9Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada (Desveaux, Shuldiner, Tadrous, Ivers, Lapointe-Shaw)
11Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada (Kiran, Lofters, Martin, Ivers)
15Department of Family Medicine, Women’s College Hospital, Toronto, Ontario, Canada (Martin, Ivers)
MD, PhD
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Lauren Lapointe-Shaw
2ICES, Toronto, Ontario, Canada (Austin, Bai, Kiran, Paterson, Tadrous, Ivers, Lapointe-Shaw)
3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Austin, Desveaux, Kiran, Martin, Paterson, Ivers, Lapointe-Shaw)
6Department of Medicine, University of Toronto, Toronto, Ontario, Canada (Bhatia, Lapointe-Shaw)
9Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada (Desveaux, Shuldiner, Tadrous, Ivers, Lapointe-Shaw)
22Division of General Internal Medicine and Geriatrics, University Health Network and Sinai Health System, Toronto, Ontario, Canada (Lapointe-Shaw)
MD, PhD
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  • For correspondence: lauren.lapointe.shaw@mail.utoronto.ca

SUPPLEMENTAL MATERIALS IN PDF FILE BELOW

Supplemental Table 1.  ICES Data Sources

Supplemental Table 2. Definition of Visit Types

Supplemental Table3. Operational Definitions of All Variables

Supplemental Table 4. Characteristics of Patients in the Unmatched Cohort

Supplemental Table 5. Top 20 Visit Diagnoses for Patients in the Matched Cohort

Supplemental Table 6. Relative Risk of Having an ED Visit After an Encounter With a Within-Group Physician Compared to With a Walk-In Clinic Physician, Stratified by Age and Rurality

Supplemental Table 7. Characteristics of Patients in the Unmatched Weekend-Only Cohort

Supplemental Table 8. Characteristics of Patients in the Matched Weekend-Only Cohort

Supplemental Table 9. Top 20 Diagnoses for Patients in the Weekend-Only Matched Cohort

Supplemental Table 10. Propensity Score-Matched Outcomes for Visits on  a Weekend

Supplemental Figure 1. Study Population Flowchart

Supplemental Figure 2a. Kaplan-Meier Curve of Time to ED Visit for Patients Who Visited a Walk-In Physician They Were Not Enrolled to, Anytime (Blue Line) and Patients Who Visited a Within-Group MD They Were Not Enrolled to, During After Hours or on a Weekend (Red Line)

Supplemental Figure 2b. Kaplan-Meier Curve of Time to ED Visit for Patients Who Visited a Walk-In Physician They Were Not Enrolled to on a Weekend (Blue Line) and Patients Who Visited a Within-Group MD They Were Not Enrolled to on a Weekend (Red Line)

  • LapointeSuppTables1-10SuppFigures1-2.pdf

  View article

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