Laura K Muldoon

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PURPOSE Conceptual frameworks for primary care have evolved over the last 40 years, yet little attention has been paid to the environmental, structural and organizational factors that facilitate or moderate service delivery. Since primary care is now of more interest to policy makers, it is important that they have a comprehensive and balanced conceptual(More)
Primary Care and Primary Health Care are very similar terms which are often employed interchangeably, but which are also used to denote quite different concepts. Much time and energy is spent discussing which term is the appropriate one for a particular application. There is a growing recognition internationally that the two terms describe two quite(More)
PURPOSE New approaches to chronic disease management emphasize the need to improve the delivery of primary care services to meet the needs of chronically ill patients. This study (1) assessed whether chronic disease management differed among 4 models of primary health care delivery and (2) identified which practice organizational factors were independently(More)
BACKGROUND Many industrialized nations have initiated reforms in the organization and delivery of primary care. In Ontario, Canada, salaried and capitation models have been introduced in an attempt to address the deficiencies of the traditional fee-for-service model. The Ontario setting therefore provides an opportunity to compare these funding models(More)
BACKGROUND Lifestyle behaviours have significant health and economic consequences. Primary care providers play an important role in promoting healthy behaviours. We compared the performance of primary care models in delivering health promotion and identified practice factors associated with its delivery. METHODS Surveys were conducted in 137 randomly(More)
OBJECTIVE To determine which of 4 organizational models of primary care in Ontario were more community oriented. DESIGN Cross-sectional investigation using practice and provider surveys derived from the Primary Care Assessment Tool, with nested qualitative case studies (2 practices per model). SETTING Thirty-five fee-for-service family practices(More)
BACKGROUND Several jurisdictions attempting to reform primary care have focused on changes in physician remuneration. The goals of this study were to compare the delivery of preventive services by practices in four primary care funding models and to identify organizational factors associated with superior preventive care. METHODS In a cross-sectional(More)
A surprisingly large and ever-growing number of alternative models of primary care service delivery have been developed in Ontario. The models are relatively poorly understood, and it is unclear why there are so many of them. What needs of providers and of government as payer are they attempting to address? Through a literature review and interviews with(More)
OBJECTIVE To determine if patient poverty is associated with increased workload for primary care providers (PCPs). DESIGN Linkage of administrative data identifying patient poverty and comorbidity with survey data about the organizational structure of community health centres (CHCs). SETTING Ontario's 73 CHCs. PARTICIPANTS A total of 64 CHC sites(More)
The ratio of patients to physicians has long been used as a tool for measuring and planning healthcare resources in Canada. Some current changes in primary care, such as enrolment of patients with physicians, make this ratio easier to calculate, while others, such as changing practice structure, make it more complex to interpret. Based on information(More)