Evidence of Value

The Starfield model: Measuring comprehensive primary care for system benefit

AFHTO’s approach to primary care measurement focuses on the relationship with our patients and our ability to deliver the care patients value. Its objective is to optimize quality, access and total health system cost of care for patients, using indicators from Health Quality Ontario’s Primary Care Performance Measurement Framework. An article describing the model and a case study of its implementation was published in Healthcare Management Forum – The Starfield model: Measuring comprehensive primary care for system benefit.


  • Angie Heydon, MBA, Executive Director, The Association of Family Health Teams of Ontario
  • George Southey, MD, CCFP, FCFP, Dorval Medical Family Health Team


Comprehensive primary care describes the long-term relationship between patient and provider in which medical services, support for self-care, and care coordination are the foundation. Research has associated comprehensive primary care with better system quality, equity, and efficiency. A performance measurement method is needed to enable teams delivering such care to optimize their performance and to evaluate the benefits over time. This article describes “The Starfield Model”—an approach to measuring quality, capacity, and total cost of care at this scope of service—and the results achieved by a small family health team in implementing this model. This experience suggests that real benefits arise from meaningful feedback to providers. The model has the potential to work in any payment system of primary care, thereby providing insight into all types of comprehensive primary care practices.

Click here to access the full article.