Team-Based Care within Community Health Centres in Ontario, Canada and the Association with Emergency Department Visits: A Population-Based Retrospective Study
Prinicipal Investigator: Dr. Merrick Zwarenstein
Authors: Danielle M Nash, Jennifer Rayner, Stephanie N Dixon, Sara Bhatti, Samuel Garcia-Feliz, Jacqueline K Kueper, Lixia Zhang, Richard G Booth, Salimah Z Shariff, Conrad Pow, Merrick Zwarenstein
Team-based care is a primary care model that involves collaborative care between primary care providers and other professional providers. In Ontario, delivered through Community Health Centres (Ambulatory, non-emergency care provided to high need and often disadvantaged individuals, as part of Ontario's social safety net). The study objective was to identify if visits to different providers within Community Health Centres were associated with fewer emergency department visits.
We conducted a large retrospective population-based, nested case-control study using administrative data. Team-based care means that a Health Centre patient visited a provider at a Health Centre other than a primary care physician or nurse practitioner (i.e., mental health, diet and lifestyle education, community workers/ lay patient support, physical therapy, health promotion / system navigation, foot care). Almost all of these patients also received care from a Family Physician or a Primary care Nurse.
Nearly 150 000 individuals attended the 71 Community Health Centres, with 43% who received team-based care between 2019 to 2020. . Although benefits of team-based care have been established in the literature, we did not find any associations between care received from individual team-based provider types with lower emergency department visits. This suggests that while team-based care may improve the quality and comprehensiveness of primary care it does not, in this high need patient group, reduce the need for emergency care.
