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The impact of primary care reform on health system performance in Canada: a systematic review

Overview of attention for article published in BMC Health Services Research, July 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (87th percentile)
  • High Attention Score compared to outputs of the same age and source (90th percentile)

Mentioned by

policy
2 policy sources
twitter
15 tweeters

Citations

dimensions_citation
30 Dimensions

Readers on

mendeley
206 Mendeley
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Title
The impact of primary care reform on health system performance in Canada: a systematic review
Published in
BMC Health Services Research, July 2016
DOI 10.1186/s12913-016-1571-7
Pubmed ID
Authors

Renee Carter, Bruno Riverin, Jean-Frédéric Levesque, Geneviève Gariepy, Amélie Quesnel-Vallée

Abstract

We aimed to synthesize the evidence of a causal effect and draw inferences about whether Canadian primary care reforms improved health system performance based on measures of health service utilization, processes of care, and physician productivity. We searched the Embase, PubMed and Web of Science databases for records from 2000 to September 2015. We based our risk of bias assessment on the Grading of Recommendations Assessment, Development and Evaluation guidelines. Full-text studies were synthesized and organized according to the three outcome categories: health service utilization, processes of care, and physician costs and productivity. We found moderate quality evidence that team-based models of care led to reductions in emergency department use, but the evidence was mixed for hospital admissions. We also found low quality evidence that team-based models, blended capitation models and pay-for-performance incentives led to small and sometimes non-significant improvements in processes of care. Studies examining new payment models on physician costs and productivity were of high methodological quality and provided a coherent body of evidence assessing enhanced fee-for-service and blended capitation payment models. A small number of studies suggested that team-based models contributed to reductions in emergency department use in Quebec and Alberta. Regarding processes of diabetes care, studies found higher rates of testing for blood glucose levels, retinopathy and cholesterol in Alberta's team-based primary care model and in practices eligible for pay-for-performance incentives in Ontario. However pay-for-performance in Ontario was found to have null to moderate effects on other prevention and screening activities. Although blended capitation payment in Ontario contributed to decreases in the number of services delivered and patients seen per day, the number of enrolled patients and number of days worked in a year was similar to that of enhanced fee-for-service practices.

Twitter Demographics

The data shown below were collected from the profiles of 15 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 206 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 <1%
Canada 1 <1%
Unknown 204 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 40 19%
Researcher 26 13%
Student > Ph. D. Student 24 12%
Student > Bachelor 20 10%
Student > Doctoral Student 13 6%
Other 39 19%
Unknown 44 21%
Readers by discipline Count As %
Medicine and Dentistry 49 24%
Nursing and Health Professions 39 19%
Social Sciences 10 5%
Economics, Econometrics and Finance 10 5%
Psychology 8 4%
Other 31 15%
Unknown 59 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 January 2022.
All research outputs
#1,873,964
of 20,629,552 outputs
Outputs from BMC Health Services Research
#736
of 6,899 outputs
Outputs of similar age
#33,667
of 278,528 outputs
Outputs of similar age from BMC Health Services Research
#3
of 22 outputs
Altmetric has tracked 20,629,552 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,899 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.4. This one has done well, scoring higher than 89% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 278,528 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 87% of its contemporaries.
We're also able to compare this research output to 22 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 90% of its contemporaries.