ArticleCanadian family physician Medecin de famille canadien2022
Patient clustering in primary care settings: Outcomes and quality of care.
Article in Canadian family physician Medecin de famille canadien, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo determine whether neighbours who share the same family physicians have better cardiovascular and health care outcomes.
designRetrospective cohort study using administrative health databases.
settingOntario.
participantsThe study population included 2,690,482 adult patients cared for by 1710 family physicians.
interventionsAdult residents of Ontario were linked to their family physicians and the geographic distance between patients in the same panel or list was calculated. Using distance between patients within a panel to stratify physicians into quintiles of panel proximity, physicians and patients from close-proximity practices were compared with those from more-distant-proximity practices. Age- and sex-standardized incidence rates and hazard ratios from cause-specific hazards regression models were determined.
main outcome measuresThe occurrence of a major cardiovascular event during a 5-year follow-up period (2008 to 2012).
resultsPatients of panels in the closest-proximity quintile lived an average of 3.9 km from the 10 closest patients in their panel compared with 12.4 km for the 10 closest patients of panels in the distant-proximity quintile. After adjusting for various patient and physician characteristics, patients in the most-distant-proximity practices had a 24% higher rate of cardiovascular events (adjusted hazard ratio=1.24 [95% CI 1.20 to 1.28],
conclusionThe better cardiovascular outcomes observed in close-proximity panels may be related to a previously unrecognized mechanism of social connectedness that extends the effectiveness of primary care practitioners.
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