Laura Muldoon1, Jennifer Rayner, Simone Dahrouge. 1. C.T. Lamont Primary Health Care Research Centre, the Bruyère Research Institute, Ottawa, ON K1R 6S3. lmuldoon@swchc.on.ca
Abstract
OBJECTIVE: To determine if patient poverty is associated with increased workload for primary care providers (PCPs). DESIGN: Linkage of administrative data identifying patient poverty and comorbidity with survey data about the organizational structure of community health centres (CHCs). SETTING: Ontario's 73 CHCs. PARTICIPANTS: A total of 64 CHC sites (N=63 included in the analysis). MAIN OUTCOME MEASURES: Patient poverty was determined in 2 different ways: based on receipt of Ontario Drug Benefits (identifying recipients of welfare, provincial disability support, and low-income seniors' benefits) or residence in low-income neighbourhoods. Patient comorbidities were determined through administrative diagnostic data from the CHCs and the Institute for Clinical Evaluative Sciences. Primary care workload was determined by examining PCP panel size (the number of patients cared for by a full-time-equivalent PCP during a 2-year interval). RESULTS: The CHCs with higher proportions of poor patients had smaller panel sizes. The smaller panel sizes were entirely explained by the medical comorbidity profile of the poor patients. CONCLUSION: Poor patients generate a higher workload for PCPs in CHCs; however, this is principally because they are sicker than higher-income patients are. Further information is required about the spectrum of services used by poor patients in CHCs.
OBJECTIVE: To determine if patient poverty is associated with increased workload for primary care providers (PCPs). DESIGN: Linkage of administrative data identifying patient poverty and comorbidity with survey data about the organizational structure of community health centres (CHCs). SETTING: Ontario's 73 CHCs. PARTICIPANTS: A total of 64 CHC sites (N=63 included in the analysis). MAIN OUTCOME MEASURES: Patient poverty was determined in 2 different ways: based on receipt of Ontario Drug Benefits (identifying recipients of welfare, provincial disability support, and low-income seniors' benefits) or residence in low-income neighbourhoods. Patient comorbidities were determined through administrative diagnostic data from the CHCs and the Institute for Clinical Evaluative Sciences. Primary care workload was determined by examining PCP panel size (the number of patients cared for by a full-time-equivalent PCP during a 2-year interval). RESULTS: The CHCs with higher proportions of poor patients had smaller panel sizes. The smaller panel sizes were entirely explained by the medical comorbidity profile of the poor patients. CONCLUSION: Poor patients generate a higher workload for PCPs in CHCs; however, this is principally because they are sicker than higher-income patients are. Further information is required about the spectrum of services used by poor patients in CHCs.
Authors: Laura Muldoon; Simone Dahrouge; William Hogg; Robert Geneau; Grant Russell; Michael Shortt Journal: Can Fam Physician Date: 2010-07 Impact factor: 3.275
Authors: Grant M Russell; Simone Dahrouge; William Hogg; Robert Geneau; Laura Muldoon; Meltem Tuna Journal: Ann Fam Med Date: 2009 Jul-Aug Impact factor: 5.166
Authors: Simone Dahrouge; William Hogg; Meltem Tuna; Grant Russell; Rose Anne Devlin; Peter Tugwell; Elisabeth Kristjansson Journal: BMC Public Health Date: 2010-03-23 Impact factor: 3.295
Authors: Anthony McKnight; Simone N Vigod; Cindy-Lee Dennis; Susitha Wanigaratne; Hilary K Brown Journal: Can J Psychiatry Date: 2020-12 Impact factor: 4.356
Authors: Michael F Mayo-Smith; Rebecca A Robbins; Mark Murray; Rachel Weber; Pamela J Bagley; Elaina J Vitale; Neil M Paige Journal: JAMA Netw Open Date: 2022-04-01