reports

Do some physician groups see sicker patients than others? Implications for primary care policy in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy.

Manitoba Centre for Health Policy, Winnipeg, MB, Canada

Canadian policy makers are considering a variety of new policy initiatives directed at improving the effectiveness and efficiency of health care delivery, particularly in the ambulatory setting. These initiatives include monitoring the volume and types of care provided by physicians to their patients and shifting away from fee-for-service payment to methods which pay physicians according to the number of patients in their practice . a system of reimbursement based on full or partial capitation. A critical component of these and other initiatives is the generation of reliable information about how morbidity is distributed across practice populations. Without adequate attention to methods which make it possible to adjust for differential morbidity levels and hence different .need. for services which potentially vary from practice to practice, these initiatives could discourage physicians from treating patients with serious health needs, and/or penalize the providers that care for them. The aims of this study are to see how feasible it is to measure the .burden of morbidity. of physician practices using available administrative data, and to examine how levels of illness vary across practices in urban and rural Manitoba.