![]() ![]() Following the transition, UPC began decreasing by an additional 0.59%/year (95% CI: -0.69 to − 0.49, p < 0.0001) relative to the pre-transition rate. Mixed-effects segmented linear and logistic regressions were used to examine changes in outcomes while controlling for patient and provider contextual factors. Outcomes of interest were the usual provider of care index (UPC), a referral index (RI) (% of total primary care referrals for a physician’s roster made by the main provider), and emergency department (ED) visits for family practice sensitive conditions (FPSCs). Patients were attributed to physicians on an annual basis by determining the provider that billed the largest dollar amount over a 2 year period. Physicians providing comprehensive primary care that had at least 4 years of pre-transition and 2 years of post-transition data were eligible. ![]() Family physicians that transitioned from traditional FFS (tFFS) to eFFS between 20 were followed overtime. MethodĪ population-based longitudinal study was conducted using health administrative data from urban family practices in Ontario, Canada. This study examined the impact of the adoption of a patient rostering enhanced fee-for-service model (eFFS) on continuity, coordination of specialized care, and access. Although patient rostering is considered to be a cornerstone of a high performing primary care system and is believed to improve continuity and access, few studies have examined these relationships. Greater continuity and access to primary care results in improved patient health, satisfaction, and reduced healthcare costs. ![]()
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