Family Health Teams

Context

In response, in 2005, Ontario developed the Family Health Team (FHT) model. This model was designed to help Ontario come closer to achieving the goals of: 1) improved access to primary care; 2) improved quality and continuity of care; 3) increased patient and provider satisfaction; and 4) increased cost-effectiveness of primary care services.

Rationale

In 2008, the Conference Board of Canada (CBoC) was retained following a Request for Proposals to conduct a formal five-year evaluation of Family Health Teams (FHTs).

The purpose of the evaluation was to identify the early successes and opportunities for improvement of the FHT initiative as it continues to mature, including how FHTs have changed over time and how they compare with other primary care models. The findings of the evaluation are to inform on-going improvements to the program.

Objectives

This evaluation included an examination of the evolution of FHTs over time and comparisons with other primary care models, mainly Community Health Centres (CHCs) and Family Health Groups (FHGs). Particular emphasis was placed in measuring and understanding the performance of the FHTs on six evaluation domains: access, prevention and health promotion, internal coordination, specialist care coordination, patient and family centeredness, and patient support for chronic disease management. The evaluation addressed the processes and impact of FHTs, and the extent to which the objectives of the FHT vision were achieved at the FHT, provider, and patient levels.

Research Questions

The final analysis was framed by seven research questions. This report is based on a sub-set of those questions and includes:

• Have FHT structural and organizational characteristics changed over time?
• How do patients rate their experience with FHTs at follow up? Is this different from how patients in FHGs and CHCs rate their primary care experience?
• Has patient experience with FHTs changed from baseline to follow up? How does it compare to change in patient experience with FHGs and CHCs?
• What structural and organizational characteristics of FHTs are most associated with higher patient experience at Follow Up? What structural and organizational characteristics of FHTs are associated with the best- and lowest-performing FHTs? What structural and organizational characteristics of FHTs are associated with greatest improvements in patient ratings?

Methods

This evaluation used a mixed-methods approach (which combines qualitative and quantitative analyses) to answer the overall and specific research questions in each of the evaluation domains laid out in the evaluation framework. The data collection methods for the evaluation included facility, provider, and patient surveys; site visits; patient focus groups; and administrative data analysis.

The full report is posted on the Conference Board of Canada website.