Updated as of January 22, 2016 Cost has been identified as one of the priority measures for system-level performance by HQO and will therefore be eventually included in system-level performance reports. In the meantime, D2D remains the only primary care reporting process to include per capita cost data. D2D 1.0 was the first time cost data were shared with primary care providers at a team-level, although these data have been used in research and policy decision-making for several years. The inclusion of cost data fully embodies the intent of D2D to be a “START-egy”, a tool to get started at meaningful measurement in primary care. As such, the main value of these data is to initiate conversations to refine the measure based on the wisdom of frontline primary care providers to make this measure meaningful and actionable over time. It is possible that cost will function more as a system-level indicator than a metric for particular attention at the team-level.
- Unadjusted total costs do not take into account how sick patients are. Consider focusing on ADJUSTED total costs to allow comparisons between teams to be more meaningful.
- Because costs for long term care are considerably higher than costs in most other categories, costs are broken down into 4 categories: primary care, services, settings and institutions (see technical notes). Further exploration with AFHTO members may help clarify the extent to which any of these categories are sensitive to primary care interventions.
Readers are referred to emerging research (Wodchis and Laberge and others, personal communication) on health care system costs which seems to indicate that differences in costs for patient care by different models, pre-dated the implementation of the models and thus may be related to factors beyond the model of care itself.
- For more information, refer to the Health System Performance Research Network’s Guidelines on Person-Level Costing Using Administrative Databases in Ontario
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