Impact of general practitioner payment scheme on health care system in avoidable hospitalization for ambulatory care sensitive conditions

This study compares the effectiveness of primary care interventions provided by general practitioners (GP) remunerated under the fee-for-service (FFS) or alternative payment plan (APP), using hospitalization rates for ambulatory care sensitive conditions (ACSC) in select Northern British Columbia (BC) communities. This study used BC Ministry of Health hospital separation data held at Population Data BC. Bivariate statistics were used to compare hospitalization rates for ACSC between both groups. The results indicate overall hospitalization rates of ACSC were higher in APP than FFS communities. Further, several ACSC showed varying hospitalization rates (asthma, pneumonia, COPD, diabetes, angina, gastroenteritis/dehydration and convulsion/epilepsy) and length of hospitalizations (convulsion/epilepsy and dental conditions) between both groups. In summary, this research informs policy on the effectiveness of GP remuneration adopted in Northern BC using hospitalization rates for ACSC. Further research is needed to further validate the findings of this study.