Ontario's HSOs have not failed!
CMAJ 1997;157:1509
See response from: D.L. Mowat
So "Ontario's HSO [Health Service Organization] program failed -- at great expense -- to achieve its objectives." This unreferenced statement in Dr. David Mowat's article "Primary care reform: Is it time for population-based funding?" (CMAJ 1997;157[1]:43-4 [full text / résumé]) is unfair, given that the HSO program has never been properly evaluated (except for a comparison of rates of admission to hospital, which showed no apppreciable differences between HSOs and fee-for-service practices).
Within the current contract, the costs for the medical primary care services provided by the multidisciplinary HSO teams are below the province's average per capita cost. Patients do not get assembly-line care, despite some perverse incentives in the current programs.1
Ontario's HSOs failed? By what measures and what studies?
Gary Gibson, MD
Professor of Family Medicine
University of Western Ontario
Member, Mustard Task Force
Member, Kilshaw Working Group
for the Victoria Report
Grandview Medical Center
Cambridge, Ont.
Reference
- Gibson GA. Capitated practices. Do they work? [editorial]. Can Fam Physician 1996;42:589-92.
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