NOVA SBE HEALTH ECONOMICS & MANAGEMENT SEMINAR SERIES - APRIL 2025

NOVA SBE HEALTH ECONOMICS & MANAGEMENT SEMINAR SERIES - APRIL 2025

In this month’s edition of the NOVA SBE Health Economics & Management Seminar Series, Rose Anne Devlin, Full Professor in the Department of Economics at the University of Ottawa, will explore the impact of interprofessional team-based primary care on avoidable hospitalizations. Focusing on the Family Health Team model in Ontario, Canada, Professor Devlin will discuss her research on how this innovative care model affects hospitalizations for ambulatory care-sensitive conditions (ACSCs), and the implications of these findings for healthcare system efficiency and patient outcomes.

📅 Date: 30th April 2025
⏰ Time: 11:00 am (Lisbon Time)
📍 Location: Nova SBE | Room D-115

Title: Interprofessional Team-Based Primary Care and Avoidable Hospitalizations
Authors: Yihong Bai, Rose Anne Devlin, Steven Habbous, Liisa Jaakkimainen, Sisira Sarma

ABSTRACT:

Background: Many healthcare systems worldwide are experimenting with the transition from physician-based practices to interprofessional team-based primary care settings, with the aim of enhancing the provision of preventive health care services and the effective management of chronic conditions. In Ontario, Canada, the Family Health Team (FHT), a comprehensive interprofessional team-based practice, was introduced beginning in 2006 within a publicly funded universal health insurance system. This study examines the causal impact of the FHT practice setting on hospitalizations for ambulatory care sensitive conditions (ACSCs).

Methods: We used linked health administrative data from all Ontario residents under 75 years of age between 2006 and 2023 (N= 5,903,260) and conducted a stacked difference-in-differences analysis. Patients enrolled in a FHT each year within an age- and sex-adjusted capitation payment system constituted the treatment group, whereas patients enrolled in a similar FHT five years later served as the control group. Given the observed differences between the treated and control groups, we employed the entropy balancing technique using pre-FHT period data to balance the observed characteristics of each stack. The outcomes included (i) experiencing at least one ACSC hospitalization, (ii) total length of stay (LOS) for all ACSC hospitalizations, and (iii) total ACSC hospitalization costs in 2023 Canadian dollars.

Results: Patients enrolled in FHTs have a 0.059 percentage points (p<0.01) reduced probability of ACSC hospitalization, a reduced LOS by 0.008 days (p<0.01), and lower ACSC hospitalization costs by $18.5 (p<0.01) per patient per year. Event-study analyses indicated that these benefits persist over time. Stratified analyses revealed that urban, deprived, and male patient populations experienced the most pronounced effects of reduced ACSC hospitalizations.

Conclusion: A change in the primary care practice setting from a physician-centered capitation payment system to interprofessional team-based care decreased ACSC hospitalizations, associated lengths of stay, and costs. Policymakers may leverage these findings to optimize interprofessional team-based primary care, particularly for patients with diagnosed chronic conditions, to enhance health system efficiency and improve patient health outcomes.

SHORT BIOGRAPHY: ROSE ANNE DEVLIN

Rose Anne Devlin is a Full Professor in the Department of Economics at the University of Ottawa; she chaired the department from 2002 to 2008 and was Vice-Dean of Research for the Faculty of Social Sciences, 2011-2017. Professor Devlin’s research centers on public policy questions. Over the past twenty or so years, she has published extensively on the economics of health care, focusing on primary health care and the role of payment schemes, the structure of physician practices on health provision, the link between social capital and insurance and health care access.

She has published in top international field journals, including: Journal of Public Economics, Journal of Health Economics, National Tax Journal, Journal of Legal Studies and Journal of Risk and Insurance; as well as international general journals like the European Economic Review, and the Scandinavian Journal of Economics. Her work has been presented at a large number of national and international events.