SynthesisBMC health services research2016
The impact of primary care reform on health system performance in Canada: a systematic review.
Synthesis in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- General practice incentives: a review of the international literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Pooled it
- Impact of team-based primary care on health care utilization among patients with mental and substance use disorders: a systematic review of English-language articles.Family practice · 2025Pooled it
- Mapping Evidence and Constructing an Analytic Framework: An Umbrella Review Summarizing Primary Care Family Physicians' Experiences With Clinical Integration.Annals of family medicine · 2025Pooled it
- Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic.BMC primary care · 2023Trial
- Healthcare cost trajectories with a multidisciplinary team model: a three-year follow-up from Finnish primary and secondary care.Scandinavian journal of primary health care · 2026Article
- The Learning Cycle method: an approach to rapidly bring evidence to the point of decision-making for health system planning.Health research policy and systems · 2026Article
- Team-based care within community health centres in Ontario, Canada and the association with emergency department visits: a population-based retrospective study.BMC primary care · 2026Article
- Biomedical dominance and the underrepresentation of primary care: An analyses of self-claimed research priorities of German medical schools.The European journal of general practice · 2025Article
- How to improve the construction efficiency of key medical disciplines: a three-stage DEA.Cost effectiveness and resource allocation : C/E · 2025Article
- Preserving Continuity and Trust in Primary Care: Strategies for Implementing Team-Based Models in South Tyrol, Italy.International journal of environmental research and public health · 2025Article
- Investigation of rural-urban differences in hospitalization for ambulatory care-sensitive conditions: Analysis of linked survey, hospitalization, and tax data from Canada.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- "You do it for the patient": a qualitative analysis of changes to primary care nurses' workplace demands and resources during the COVID-19 pandemic in Canada.Frontiers in health services · 2025Article
- Transformation of primary care settings implementing a co-located team-based care model: a scoping review.BMC health services research · 2024Article
- Impact of reimbursement systems on patient care - a systematic review of systematic reviews.Health economics review · 2024Review
- Levels and related factors of occupational stress among nurses: hospital-based evidence from China, 2023.Frontiers in psychology · 2024Article
- The Patient's Perspective on the Functioning of the Primary Healthcare Centres in Bangalore, India: An Illustrated Guide.Journal of patient experience · 2024Article
- The impact of team-based primary care on medication-related outcomes in older adults: A comparative analysis of two Canadian provinces.Preventive medicine reports · 2023Article
- Alternative Reimbursement Models for Health Providers in High-Performance Sport: Stakeholder Experiences and Perceptions.Sports medicine - open · 2023Article
- Article
- A North Star Vision: Results from a Deliberative Dialogue to Identify Policy Strategies to Improve Value in Healthcare.Healthcare policy = Politiques de sante · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundWe aimed to synthesize the evidence of a causal effect and draw inferences about whether Canadian primary care reforms improved health system performance based on measures of health service utilization, processes of care, and physician productivity.
methodsWe searched the Embase, PubMed and Web of Science databases for records from 2000 to September 2015. We based our risk of bias assessment on the Grading of Recommendations Assessment, Development and Evaluation guidelines. Full-text studies were synthesized and organized according to the three outcome categories: health service utilization, processes of care, and physician costs and productivity.
resultsWe found moderate quality evidence that team-based models of care led to reductions in emergency department use, but the evidence was mixed for hospital admissions. We also found low quality evidence that team-based models, blended capitation models and pay-for-performance incentives led to small and sometimes non-significant improvements in processes of care. Studies examining new payment models on physician costs and productivity were of high methodological quality and provided a coherent body of evidence assessing enhanced fee-for-service and blended capitation payment models.
conclusionA small number of studies suggested that team-based models contributed to reductions in emergency department use in Quebec and Alberta. Regarding processes of diabetes care, studies found higher rates of testing for blood glucose levels, retinopathy and cholesterol in Alberta's team-based primary care model and in practices eligible for pay-for-performance incentives in Ontario. However pay-for-performance in Ontario was found to have null to moderate effects on other prevention and screening activities. Although blended capitation payment in Ontario contributed to decreases in the number of services delivered and patients seen per day, the number of enrolled patients and number of days worked in a year was similar to that of enhanced fee-for-service practices.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.