Article Figures & Tables
Figures
- Figure 1
Study flow diagram showing patient selection. *Exclusions not mutually exclusive. Note: CHRIS = Client Health and Related Information System, CCP = coordinated care plan, LHIN = Local Health Integration Network, RPDB = Registered Persons Database.
Tables
- Table 1: Comparison of characteristics of Health Links enrollees and comparator patients, before and after matching*
Characteristic No. (%) of patients† Before matching After matching Enrollees
n = 344Full comparator pool
n = 34 820SDiff Enrollees
n = 313Comparator patients
n = 313SDiff Age at index date, mean ± SD, yr 75.5 ± 14.3 69.9 ± 15.5 0.376 75.6 ± 13.9 75.5 ± 15.0 0.010 Male sex 136 (39.5) 15 470 (44.4) 0.099 126 (40.3) 125 (39.9) 0.007 Area-based income quintile 1 (lowest) 66 (19.2) 4708 (13.5) 0.154 58 (18.5) 64 (20.4) 0.048 2 65 (18.9) 5548 (15.9) 0.078 58 (18.5) 59 (18.8) 0.008 3 65 (18.9) 7526 (21.6) 0.068 61 (19.5) 65 (20.8) 0.032 4 82 (23.8) 9676 (27.8) 0.090 76 (24.3) 69 (22.0) 0.053 5 (highest) 66 (19.2) 7362 (21.1) 0.049 60 (19.2) 56 (17.9) 0.033 Rurality Index of Ontario score, mean ± SD 6.7 ± 9.1 5.1 ± 6.8 0.207 6.4 ± 8.9 6.8 ± 8.6 0.045 Health Link South Simcoe 168 (48.8) 8846 (25.4) 0.500 152 (48.6) 155 (49.5) 0.019 Southwest York 12 (3.5) 13 895 (39.9) 0.985 12 (3.8) 16 (5.1) 0.062 North York Central 164 (47.7) 12 079 (34.7) 0.266 149 (47.6) 142 (45.4) 0.045 Primary care model affiliation Family Health Team 56 (16.3) 2928 (8.4) 0.241 52 (16.6) 53 (16.9) 0.009 Family Health Group 123 (35.8) 15 711 (45.1) 0.192 115 (36.7) 105 (33.5) 0.067 Family Health Organization 110 (32.0) 9006 (25.9) 0.135 97 (31.0) 105 (33.5) 0.055 Other 9 (2.6) 1302 (3.7) 0.064 7 (2.2) 9 (2.9) 0.040 Not rostered in a model 46 (13.4) 5873 (16.9) 0.098 42 (13.4) 41 (13.1) 0.009 Comorbidity (CADGs 1-12) Acute minor 332 (96.5) 29 315 (84.2) 0.427 301 (96.2) 304 (97.1) 0.053 Acute major 332 (96.5) 31 134 (89.4) 0.280 301 (96.2) 304 (97.1) 0.053 Likely to recur 286 (83.1) 25 326 (72.7) 0.253 257 (82.1) 254 (81.2) 0.025 Asthma 52 (15.1) 4131 (11.9) 0.095 45 (14.4) 39 (12.5) 0.056 Chronic medical unstable 330 (95.9) 27 667 (79.4) 0.518 299 (95.5) 302 (96.5) 0.049 Chronic medical stable 315 (91.6) 30 039 (86.3) 0.169 285 (91.0) 283 (90.4) 0.022 Chronic specialty stable 34 (9.9) 3150 (9.0) 0.029 33 (10.5) 35 (11.2) 0.021 Eye/dental 55 (16.0) 4569 (13.1) 0.081 53 (16.9) 51 (16.3) 0.017 Chronic specialty unstable 80 (23.2) 7008 (20.1) 0.076 68 (21.7) 74 (23.6) 0.046 Psychosocial 238 (69.2) 20 928 (60.1) 0.191 213 (68.0) 204 (65.2) 0.061 Preventive/administrative 221 (64.2) 10 477 (30.1) 0.728 197 (62.9) 191 (61.0) 0.039 Pregnancy Suppr. 308 (0.9) 0.078 Suppr. Suppr. 0.000 Use in prior year, mean ± SD Dialysis visits 1.2 ± 12.4 1.1 ± 12.6 0.008 0.9 ± 10.5 1.5 ± 14.6 0.052 Oncology visits 0.5 ± 3.5 0.6 ± 3.7 0.032 0.4 ± 3.2 0.4 ± 2.8 0.018 Primary care visits 26.4 ± 22.0 16.4 ± 14.2 0.539 24.7 ± 20.5 24.7 ± 17.5 0.001 Specialist visits 66.4 ± 47.7 25.8 ± 29.2 1.026 62.9 ± 46.7 64.5 ± 52.2 0.031 Home care services 121.5 ± 176.3 22.7 ± 79.2 0.722 114.2 ± 171.6 126.4 ± 187.3 0.068 Mental hospital admissions 0.1 ± 0.5 0.0 ± 0.3 0.122 0.1 ± 0.5 0.1 ± 0.3 0.057 Emergency department visits in previous year, mean ± SD First quarter 2.4 ± 2.7 0.4 ± 1.0 0.985 2.2 ± 2.3 2.3 ± 2.9 0.044 Second quarter 1.5 ± 2.6 0.4 ± 1.0 0.584 1.4 ± 2.1 1.3 ± 2.0 0.042 Third quarter 1.2 ± 1.9 0.4 ± 1.0 0.569 1.1 ± 1.7 1.1 ± 1.9 0.000 Fourth quarter 1.2 ± 2.2 0.3 ± 0.9 0.498 1.0 ± 1.8 1.0 ± 2.2 0.011 Hospital admissions in previous year, mean ± SD First quarter 1.2 ± 1.1 0.1 ± 0.4 1.316 1.1 ± 1.0 1.1 ± 0.9 0.024 Second quarter 0.6 ± 0.9 0.1 ± 0.4 0.680 0.6 ± 0.9 0.5 ± 0.8 0.064 Third quarter 0.5 ± 0.8 0.1 ± 0.4 0.571 0.4 ± 0.7 0.4 ± 0.7 0.055 Fourth quarter 0.4 ± 0.8 0.1 ± 0.4 0.414 0.3 ± 0.8 0.3 ± 0.6 0.090 Note: CADGs = Johns Hopkins Collapsed Adjusted Clinical Groups, SD = standard deviation, SDiff = standardized difference, Suppr. = cell suppressed owing to small number (n < 5).
*Only mean values and SDs are reported for continuous variables. Median values were also balanced between groups after matching.
†Except where noted otherwise.
Measure; group Rate or mean (95% CI) Pre-post difference, IRR (95% CI) Difference-in-differences
(95% CI)Before index date* After index date Hospital admissions† Health Links enrollees 2.26 (2.06-2.49) 2.07 (1.81-2.36) 0.91 (0.79-1.05) 1.74 (1.40-2.17) Comparator group 2.06 (1.89-2.26) 1.08 (0.91-1.29) 0.53 (0.44-0.63) Emergency department visits† Health Links enrollees 3.02 (2.42-3.78) 3.10 (2.09-4.59) 1.02 (0.80-1.31) 1.61 (1.18-2.20) Comparator group 3.52 (2.97-4.18) 2.24 (1.72-2.9) 0.64 (0.52-0.77) Days in acute care† Health Links enrollees 18.4 (16.3-20.8) 24.9 (20.7-30.0) 1.35 (1.11-1.65) 1.51 (1.06-2.15) Comparator group 19.9 (17.3-23.1) 17.9 (13.5-23.8) 0.90 (0.66-1.21) 30-day readmissions, %‡ Health Links enrollees 30.4 (26.1-35.4) 36.2 (31.2-41.9) 1.19 (0.95-1.49) 1.43 (0.96-2.13) Comparator group 25.6 (22.2-29.5) 21.2 (16.2-27.8) 0.83 (0.61-1.14) 7-day primary care follow-up, %‡ Health Links enrollees 36.5 (32.6-41.9) 37.5 (32.7-43.1) 1.03 (0.88-1.20) 1.01 (0.76-1.33) Comparator group 34.9 (31.0-39.3) 35.7 (29.0-44.0) 1.02 (0.82-1.28) Note: CI = confidence interval, IRR = incidence rate ratio.
*All comparisons (enrollees v. comparator patients) were nonsignificant.
†Rate per person-year.
‡Per index hospital admission.
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