Cancer screening inequities in a time of primary care reform: a population-based longitudinal study in Ontario, Canada

BMC Family Practice
Aisha K LoftersSimone Dahrouge

Abstract

Primary care has been reformed in recent years in Ontario, Canada, with a move away from traditional fee-for-service to enhanced fee-for-service and capitation-based models. It is unclear how new models have affected disparities in cancer screening. We evaluated whether Ontario's enhanced fee-for-service model was associated with a change in the gaps in cancer screening for people living with low income and people who are foreign-born. We conducted a population-based longitudinal analysis from 2002 to 2013 of Ontario family physicians who transitioned from traditional fee-for-service to enhanced fee-for-service. The binary outcomes of interest were adherence to cervical, breast and colorectal cancer screening recommendations. Outcomes were analyzed using mixed-effects logistic regression. Analyses produced annual odds ratios comparing the odds of being up-to-date for screening among patients in enhanced fee-for-service versus patients in traditional fee-for-service for each social stratum separately. We calculated the ratios of stratum-specific odds ratios to assess whether the transition from traditional to enhanced fee-for-service was associated with a change in screening gaps between immigrants and long-term residents, and b...Continue Reading

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Citations

Aug 29, 2019·Primary Health Care Research & Development·Catherine DonnellyCarol Mulder
Dec 14, 2018·International Journal for Equity in Health·Simone DahrougeTed Schrecker
Jan 7, 2021·Journal of the National Comprehensive Cancer Network : JNCCN·Omar Abdel-Rahman
Jun 3, 2021·Current Oncology·Aisha K LoftersGeetanjali D Datta

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