Team-based versus traditional primary care models and short-term outcomes after hospital discharge.

Team-based versus traditional primary care models and short-term outcomes after hospital discharge. CMAJ. 2017 Apr 24;189(16):E585-E593 Authors: Riverin BD, Li P, Naimi AI, Strumpf E Abstract BACKGROUND: Strategies to reduce hospital readmission have been studied mainly at the local level. We assessed associations between population-wide policies supporting team-based primary care delivery models and short-term outcomes after hospital discharge. METHODS: We extracted claims data on hospital admissions for any cause from 2002 to 2009 in the province of Quebec. We included older or chronically ill patients enrolled in team-based or traditional primary care practices. Outcomes were rates of readmission, emergency department visits and mortality in the 90 days following hospital discharge. We used inverse probability weighting to balance exposure groups on covariates and used marginal structural survival models to estimate rate differences and hazard ratios. RESULTS: We included 620 656 index admissions involving 312 377 patients. Readmission rates at any point in the 90-day post-discharge period were similar between primary care models. Patients enrolled in team-based primary care practices had lower 30-day rates of emergency department visits not associated with readmission (adjusted difference 7.5 per 1000 discharges, 95% confidence interval [CI] 4.2 to 10.8) and lower 30-day mortality (adjusted difference 3.8 deaths p...
Source: cmaj - Category: Journals (General) Authors: Tags: CMAJ Source Type: research