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The effect of enrolment policies on patient affiliation to a family physician: A quasi-experimental evaluation in Canada

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  • King, Caroline
  • Lavergne, M. Ruth
  • McGrail, Kimberlyn
  • Strumpf, Erin

Abstract

Affiliation, defined as having a usual source of care, revealed by patterns of repeated interactions between the patient and a clinician over time, can influence patients’ care experience, continuity of care and health outcomes. Many jurisdictions implement primary care enrolment policies, with the motivation to increase affiliation and thereby improve downstream patient outcomes. However, there is little evidence on the impacts of these policies on patient-physician affiliation.

Suggested Citation

  • King, Caroline & Lavergne, M. Ruth & McGrail, Kimberlyn & Strumpf, Erin, 2025. "The effect of enrolment policies on patient affiliation to a family physician: A quasi-experimental evaluation in Canada," Health Policy, Elsevier, vol. 156(C).
    • Handle: RePEc:eee:hepoli:v:156:y:2025:i:c:s0168851025000697
    DOI: 10.1016/j.healthpol.2025.105313
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    References listed on IDEAS

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    1. David Rudoler & Raisa Deber & Janet Barnsley & Richard H. Glazier & Adrian Rohit Dass & Audrey Laporte, 2015. "Paying for Primary Care: The Factors Associated with Physician Self‐selection into Payment Models," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1229-1242, September.
    2. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    3. Claude Forget, 2014. "The Case of the Vanishing Quebec Physicians: How to Improve Access to Care," C.D. Howe Institute Commentary, C.D. Howe Institute, issue 410, May.
    4. Caroline King & M Ruth Lavergne & Kimberlyn McGrail & Erin C Strumpf & on behalf of the Quebec-British Columbia Patient Enrolment Project Team, 2024. "Reporting a regular medical doctor index: A new measure of patient-physician affiliation for health administrative data," PLOS ONE, Public Library of Science, vol. 19(12), pages 1-14, December.
    5. Coyle, Natalie & Strumpf, Erin & Fiset-Laniel, Julie & Tousignant, Pierre & Roy, Yves, 2014. "Characteristics of physicians and patients who join team-based primary care practices: Evidence from Quebec's Family Medicine Groups," Health Policy, Elsevier, vol. 116(2), pages 264-272.
    6. Lavergne, M. Ruth & Law, Michael R. & Peterson, Sandra & Garrison, Scott & Hurley, Jeremiah & Cheng, Lucy & McGrail, Kimberlyn, 2018. "Effect of incentive payments on chronic disease management and health services use in British Columbia, Canada: Interrupted time series analysis," Health Policy, Elsevier, vol. 122(2), pages 157-164.
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