What is the potential for formal patient registration in Canadian primary care? The scale of informal registration' in Manitoba

摘要

Objectives:Objectives: Registration of patients with a physician is increasingly being considered across Canada as part of anreform of the primary health care system. This study aims to determine how much ‘informal registration’ currentlynexists; that is, to identify the number/proportion of patients who, given existing utilization patterns, already receiventhe majority of their care from one practice, in order to assess the potential for formal registration.nMethods: Administrative data were used to classify patients (nˆ528 905) as being informally registered with anclinic if they received the majority of their care (75% or more of their total ambulatory visits) from the same practicenover a three-year period (1994-1996). The proportion and number of informally registered patients were examined.nResults: Substantial variability emerged across practices in the proportion of informally registered patients (15-n68%) and the number of informally registered patients per physician (544-1378 patients per full-time equivalentnphysician). Informal registration was higher among rural practices (60%) than among urban practices (38%).nConclusions: While formal registration of patients with physicians is increasingly being considered in Canada as anmeans to improve the primary care system, the potential disruption to both patients and physicians in movingntowards registration should not be underestimated. The relatively low levels of existing informal registration suggestna need to enhance access by, for example, providing after-hours services.