BACKGROUND: Primary care providers play an important role in preventing and managing @entity65 . This study compared the quality of preventive cardiovascular care delivery amongst different primary care models. METHODS: This is a secondary analysis of a larger randomized control trial, known as the Improved Delivery of Cardiovascular Care (IDOCC) through Outreach Facilitation. Using baseline data collected through IDOCC, we conducted a cross-sectional study of 82 primary care practices from three delivery models in Eastern Ontario, Canada: 43 fee-for-service, 27 blended-capitation and 12 community health centres with salary-based physicians. Medical chart audits from 4,808 @entity1 with or at high risk of developing @entity65 were used to examine each practice's adherence to ten evidence-based processes of care for @entity6 , @entity740 , @entity2299 , @entity101 , weight management, and smoking cessation care. Generalized estimating equation models adjusting for age, sex, rurality, number of cardiovascular-related comorbidities, and year of data collection were used to compare guideline adherence amongst the three models. RESULTS: The percentage of @entity1 with @entity6 that received two hemoglobin A1c tests during the study year was significantly higher in community health centres (69%) than in fee-for-service (45%) practices (Adjusted Odds Ratio (AOR) = 2.4 [95% CI 1.4-4.2], p = 0.001). Blended capitation practices had a significantly higher percentage of @entity1 who had their waistlines monitored than in fee-for-service practices (19% vs. 5%, AOR = 3.7 [1.8-7.8], p = 0.0006), and who were recommended a smoking cessation drug when compared to community health centres (33% vs. 16%, AOR = 2.4 [1.3-4.6], p = 0.007). Overall, quality of @entity6 care was higher in community health centres, while smoking cessation care and weight management was higher in the blended-capitation models. Fee-for-service practices had the greatest gaps in care, most noticeably in @entity6 care and weight management. CONCLUSIONS: This study adds to the evidence suggesting that primary care delivery model impacts quality of care. These findings support current Ontario reforms to move away from the traditional fee-for-service practice. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00574808.

Comparison of primary care models in the prevention of XXXX - a cross sectional study.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity2299 :: ('MESH:D050171', 'Disease') :: ['dyslipidemia'] @entity740 :: ('MESH:D051436', 'Disease') :: ['chronic kidney disease'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular disease']
@entity65 :: (MESH:D002318,Disease) :: ['cardiovascular disease']
