Evidence map›Paper›PMID 31300443›Full record

ArticleCanadian family physician Medecin de famille canadien2019

Effect of primary health care reforms in the province of Newfoundland and Labrador: Interrupted time-series analysis.

John C Knight, Rahim Moineddin, Maria Mathews, Kris Aubrey-Bassler

Abstract read
In one paragraph

Article in Canadian family physician Medecin de famille canadien, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

John C KnightResearch Associate in the Primary Healthcare Research Unit and Adjunct Professor in the Division of Community Health and Humanities at Memorial University of Newfoundland in St John's, and Senior Epidemiologist in the Health Analytics and Evaluation Services Department in the Newfoundland and Labrador Centre for Health Information.
Rahim MoineddinProfessor in the Department of Family and Community Medicine and in the Biostatistics Division at the Dalla Lana School of Public Health at the University of Toronto in Ontario.
Maria MathewsAt the time of writing, Dr Mathews was Professor in the Division of Community Health and Humanities at Memorial University of Newfoundland.
Kris Aubrey-BasslerAssociate Professor in the Discipline of Family Medicine and Director of the Primary Healthcare Research Unit at Memorial University of Newfoundland. kaubrey@mun.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine the effects of primary health care (PHC) reforms in the Canadian province of Newfoundland and Labrador on ambulatory care-sensitive (ACS) hospitalization rates and mortality.

designInterrupted time-series analysis of administrative data.

settingAll communities in the province of Newfoundland and Labrador were divided into 3 groups: rural reform (n = 69 143), rural nonreform (n = 228 914), and urban nonreform (n = 197 012). No urban communities introduced PHC reforms.

participantsAll residents of the province who held a valid health card and did not change their address during the 2001-2009 study period were included. Individuals were assigned to 1 of the 3 study groups based on community of residence.

main outcome measuresHospitalization rates for ACS conditions, hospitalization rates for control conditions, and ACS-related mortality were compared using interrupted time-series models.

resultsResults are reported as rate ratio or odds ratio (OR) (95% CI). In rural reform and rural nonreform communities, there was a decreasing trend in ACS hospitalization rates that preceded reforms (rate ratio of 0.97 [0.94-1.00]) and rate ratio of 0.98 [0.96-1.00], respectively) but no change following reforms. There were no significant changes in the urban group. In all 3 groups, there was a significant increasing trend in ACS-related mortality before reforms (OR of 1.09 [1.02-1.15], OR of 1.10 [1.06-1.13], and OR of 1.09 [1.05-1.14] for rural reform, rural nonreform, and urban communities, respectively), which was reversed after the introduction of reforms (

conclusionPrimary health care reforms in Newfoundland and Labrador had no observed effect on ACS hospitalization rates, but a potential effect might have been masked by a decreasing trend that preceded the introduction of reforms. The increase in mortality rates that was reversed after the introduction of reforms cannot be attributed to the reforms because it occurred in all studied populations including those that did not introduce reforms.

Indexed as

Ambulatory CareHealth Care ReformHealth Services AccessibilityRural Health ServicesHospitalizationHumansInterrupted Time Series AnalysisMortalityMultivariate AnalysisNewfoundland and LabradorRegression Analysis

Identifiers

PMID31300443
PMCPMC6738472

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