Complexity of Care study in FHTs with BSM physicians – confirm participation by July 4, 2011

Are CFHTs different from the wider FHT sector?  Is the difference more than just the governance model?  Now you can find out.

The Association of Ontario Health Centres (AOHC) and the Association of Family Health Teams of Ontario (AFHTO) invite FHTs who have physicians on the blended salary model to participate in a research project to determine the complexity of care and the individual characteristics of your patients and how it compares to other primary healthcare models across Ontario.

This project is in collaboration with the Institute for Clinical Evaluative Sciences (ICES).  The objective is to describe the patients that you see and to quantify the social and medical complexity of your patients. The need to demonstrate how numerous influences make a patient more or less complex is vital for CFHTs to enable them to demonstrate the important role they play in the provision of primary health care.

Why would you participate in this research study?

  • To produce a socio-demographic profile, a case-mix description, and a performance report for each CFHTs in Ontario which use the BSM payment model;
  • To understand better the patterns of health care service delivery to your patients and populations with differing needs;
  • To match health care resources more closely with health care needs;
  • To enable you to advocate for your practice and tell your CFHT story.

How will it be completed?

  • guidelines of PHIPA will be followed and research ethics approval will be received before this project begins.
  • Data sharing agreements will be signed so that we can have access to your data.
  • AOHC will sign a data sharing agreement for all interested AOHC members
  • Individual data sharing agreements will be signed with FHTs who are not members of AOHC
  • a small data set will be required that includes the patient’s health card number, postal code, date of birth, gender, diagnoses over a two year period.
  • data will be analyzed at ICES and detailed individual reports will be prepared for each participating CFHT; Data will only be used for the intended purposes.

What is the cost?

  • No cost for AOHC members who have paid at least half of their annual dues.
  • $1200 for non-AOHC members: this will recover the costs of data management, generating all SAS code and the production of a final report.
  • ICES provides services and charges that are established on a cost-recovery basis.

What will each CFHT receive?

Report will include:

  • tables comparing the aggregate CFHT information with the comparison models (CHCs, FHTs, FHNs, FHOs, FHGs, Not-Enrolled).
  • Socio-demographic characteristics of the individual CFHT clients including age, sex, urban-rural residence, area-level income, newcomers with OHIP registration within ten years, and those receiving medications through welfare, disability, and seniors with low income.
  • comparison comorbidity characteristics (previous acute myocardial infarction (AMI), Congestive heart failure (CHF), hypertension, asthma, COPD, mental health, mean resource utilization bands and the number of aggregate diagnostic groups (a measure of comorbidity).
  • comparison of emergency department utilization by triage level, avoidable hospital admissions and chronic disease prevention and management.

Outcomes will be presented in relation to those expected given each CFHT’s demographics and case mix.

Data for each CFHT will be made available to that CFHT. No individual-level data will be provided or reported at the level of patients.

How much time will it take? June 21- September 30:

June 21:               You are invited to participate in a no obligation webinar that will outline the study.  You will have an opportunity to ask questions

By July 4:             We need your response as to whether you will participate; upon confirmation that you will participate, we will send data sharing agreements to sign and return

July 2011:            We will require you to extract data from your clinical management software (assistance provided by Jennifer Rayner, Regional Decision Support Specialist in the Southwest region)

Aug 2011:            Analysis by ICES (no time or work for you and your centre)

By Sept 30:          Reports will be prepared and delivered to your CFHT

Why are only CFHTs operating with a Blended Salary Model included?

We are extracting data from the patient encounters because your data does not get shadow-billed through OHIP. This type of analysis is already being conducted at ICES for other models. This project will enable you to get access to this data for your centre.

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