Explaining Primary Care Physicians' Decision to Quit Patient-centered Medical Homes: Evidence from Quebec, Canada

Overview

Journal Health Serv Res

Specialty Health Services

Date 2019 Feb 8

PMID 30729507

Citations 2

Authors

Mehdi Ammi

Mamadou Diop

Erin Strumpf

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the factors explaining primary care physicians' (PCPs) decision to leave patient-centered medical homes (PCMHs).

Data Sources: Five-year longitudinal data on all the 906 PCPs who joined a PCMH in the Canadian province of Quebec, known there as a Family Medicine Group.

Study Design: We use fixed-effects and random-effects logit models, with a variety of regression specifications and various subsamples. In addition to these models, we examine the robustness of our results using survival analysis, one lag in the regressions and focusing on a matched sample of quitters and stayers.

Data Collection/extraction Methods: We extract information from Quebec's universal health insurer billing data on all the PCPs who joined a PCMH between 2003 and 2005, supplemented by information on their elderly and chronically ill patients.

Principal Findings: About 17 percent of PCPs leave PCMHs within 5 years of follow-up. Physicians' demographics have little influence. However, those with more complex patients and higher revenues are less likely to leave the medical homes. These findings are robust across a variety of specifications.

Conclusion: As expected, higher revenue favors retention. Importantly, our results suggest that PCMH may provide appropriate support to physicians dealing with complex patients.

Citing Articles

Developing Interprofessional Primary Care Teams: Alumni Evaluation of the Department of Veterans Affairs Centers of Excellence in Primary Care Education Program.

Harada N, Rajashekara S, Sansgiry S, Wirtz Rugen K, King S, Gilman S J Med Educ Curric Dev. 2022; 6:2382120519875455.

PMID: 35187259 PMC: 8855379. DOI: 10.1177/2382120519875455.

Explaining primary care physicians' decision to quit patient-centered medical homes: Evidence from Quebec, Canada.

Ammi M, Diop M, Strumpf E Health Serv Res. 2019; 54(2):367-378.

PMID: 30729507 PMC: 6407354. DOI: 10.1111/1475-6773.13120.

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