This project tested primary care reform at seven pilot sites across the province, one of the first steps in an Ontario government–Ontario Medical Association joint initiative to implement major province-wide primary health care reform. The goal of reform is to move away from individual physician care to networks of physicians (primary care networks) that enrol patients for the provision and coordination of primary care services. This evaluation report is a preliminary accounting of what has occurred up until the spring of 2001, by which time 11 networks had enrolled 218,398 patients and physician-patient ratios varied from 1:430 to 1:2,245. The key aspects of the primary care networks include population-based funding for services (either through “reformed fee-for-service” or through “global capitation” mechanisms); the enrolment of patients; a telephone triage system after hours; incentives for preventive interventions, and the use of information technology to better coordinate services. In this draft report, physicians felt that it was too early to notice much change in their practices, although most seemed satisfied with primary care reform steps. The short duration of the evaluation to date limits the ability to draw conclusions about cost-effectiveness. The government is committed to having 80 per cent of family doctors voluntarily join the “Ontario Family Health Networks” by 2004 and plans an investment of $250 million to establish these networks. The HTF contributed $18 million for the pilot projects; this is the final report of the first phase of evaluation.
This project was supported by the Health Transition Fund, which was created in 1997 to provide support for evidence-based decision-making in health care reform by supporting pilot and evaluation projects which test innovative approaches to health care delivery. The views expressed herein do no necessarily represent the official policy of federal, provincial, or territorial governments.