Twelve-month outcomes for patients cared for by primary care physicians in Alberta 2008–2010
| Outcomes | No. of events in patients in a primary care network* n = 1 502 916 | No. of events in patients in conventional primary care n = 1 109 940 | Crude RR (95% CI) | Clinically adjusted RR† (95% CI) | Fully adjusted RR‡ (95% CI) | Matched§ cohort analysis with conditional RR (95% CI) |
|---|---|---|---|---|---|---|
| Emergency department visit | ||||||
| Patient Medical Home indicator conditions | n = 1 502 916 | n = 1 109 940 | ||||
| Patients with event | 21 655 (1.4%) | 18 830 (1.7%) | ||||
| Total events | 29 679 | 26 160 | 0.83 (0.81–0.85) | 0.89 (0.88–0.90) | 0.98 (0.96–0.99) | 0.87 (0.86–0.89) |
| Mean per patient | 0.031 | 0.035 | ||||
| All-cause | n = 1 502 916 | n = 1 109 940 | ||||
| Patients with event | 382 819 (25.5%) | 337 983 (30.5%) | ||||
| Total events | 830 260 | 800 039 | 0.81 (0.80–0.81) | 0.84 (0.83–0.84) | 0.93 (0.93–0.94) | 0.83 (0.83–0.83) |
| Mean per patient | 0.55 | 0.72 | ||||
| Hospital admission | ||||||
| Patient Medical Home indicator conditions | n = 1 502 916 | n = 1 109 940 | ||||
| Patients with event | 8557 (0.57%) | 6876 (0.62%) | ||||
| Total events | 11 072 | 8769 | 1.07 (1.03–1.10) | 0.93 (0.90–0.96) | 1.07 (1.03–1.11) | 0.95 (0.92–0.98) |
| Mean per patient | 0.018 | 0.017 | ||||
| All-cause | n = 1 502 916 | n = 1 109 940 | ||||
| Patients with event | 139 394 (9.3%) | 101 068 (9.1%) | ||||
| Total events | 155 631 | 121 929 | 1.06 (1.05–1.07) | 0.98 (0.97–0.99) | 1.08 (1.07–1.09) | 1.11 (1.10–1.12) |
| Mean per patient | 0.25 | 0.23 | ||||
| After excluding patients who died or emigrated from Alberta during the study period | ||||||
| Emergency department visit | ||||||
| Patient Medical Home indicator conditions | n = 1 466 259 | n = 1 067 579 | ||||
| Patients with event | 19 171 (1.3%) | 16 444 (1.5%) | ||||
| Total events | 25 625 | 22 384 | 0.90 (0.88–092) | 0.81 (0.79–0.82) | 0.96 (0.94–0.99) | 0.86 (0.84–0.88) |
| Mean per patient | 0.025 | 0.031 | ||||
| All-cause | n = 1 466 259 | n = 1 067 579 | ||||
| Patients with event | 366 475 (25%) | 319 750 (30.0%) | ||||
| Total events | 783 994 | 749 799 | 0.84 (0.84–0.84) | 0.78 (0.77–0.79) | 0.92 (0.92–0.93) | 0.81 (0.80–0.81) |
| Mean per patient | 0.53 | 0.70 | ||||
| Hospital admission | ||||||
| Patient Medical Home indicator conditions | n = 1 466 259 | n = 1 067 579 | ||||
| Patients with event | 6797 (0.5%) | 5116 (0.5%) | ||||
| Total events | 8248 | 6238 | 1.10 (1.05–1.14) | 0.90 (0.87–0.94) | 1.04 (1.00–1.09) | 1.00 (0.96–1.04) |
| Mean per patient | 0.014 | 0.012 | ||||
| All-cause | n = 1 466 259 | n = 1 067 579 | ||||
| Patients with event | 127 933 (8.7%) | 88 885 (8.3%) | ||||
| Total events | 135 284 | 101 762 | 1.09 (1.08–1.10) | 0.99 (0.99–1.00) | 1.08 (1.07–1.10) | 1.11 (1.10–1.12) |
| Mean per patient | 0.22 | 0.20 | ||||
Note: CI = confidence interval, RR = risk ratio.
↵* Patients seen by a physician affiliated with a primary care network.
↵† RR adjusted for patient demographics and clinical comorbidities.
↵‡ RR adjusted for patient demographics, comorbidities, number of visits, socioeconomic status and geographic zone.
↵§ Matched on age, sex, Charlson Comorbidity Index score and geographic zone, and restricted to patients with 2 or more visits per year.