Publications by authors named "Nibene H Some"

Improving access to primary care physicians' services may help reduce hospitalizations due to Ambulatory Care Sensitive Conditions (ACSCs). Ontario, Canada's most populous province, introduced blended payment models for primary care physicians in the early- to mid-2000s to increase access to primary care, preventive care, and better chronic disease management. We study the impact of payment models on avoidable hospitalizations due to two incentivized ACSCs (diabetes and congestive heart failure) and two non-incentivized ACSCs (angina and asthma).

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Background: Mental health problems and substance use co-morbidities during and after the COVID-19 pandemic are a public health priority. Identifying individuals at high-risk of developing mental health problems and potential sequela can inform mitigating strategies. We aimed to identify distinct groups of individuals (i.

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Background: This study examined whether heavy episodic drinking (HED), cannabis use, and subjective changes in alcohol and cannabis use during the COVID-19 pandemic differ between transgender and gender-diverse (TGD) and cisgender adults.

Methods: Successive waves of web-based cross-sectional surveys.

Setting: Canada, May 2020 to March 2021.

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Background: The COVID-19 global pandemic has increased the burden of mental illness on Canadian adults. However, the complex combination of demographic, economic, and lifestyle factors and perceived health risks contributing to patterns of anxiety and depression has not been explored.

Objective: The aim of this study is to harness flexible machine learning methods to identify constellations of factors related to symptoms of mental illness and to understand their changes over time during the COVID-19 pandemic.

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Treating mental illnesses in primary care is increasingly emphasized to improve access to mental health services. Although family physicians (FPs) or general practitioners are in an ideal position to provide the bulk of mental health care, it is unclear how best to remunerate FPs for the adequate provision of mental health services. We examined the quantity of mental health services provided in Ontario's blended fee-for-service and blended capitation models.

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Article Synopsis
  • Early detection and treatment of mental illnesses in primary care could lower psychiatric hospitalizations, prompting the WHO to recommend integrating mental health services into these settings.
  • This study examines how physician payment models in Ontario, specifically the shift from fee-for-service (FFS) to blended capitation, affect psychiatric hospitalization rates among patients.
  • Findings indicate that switching to blended capitation is linked to a 6.2% reduction in psychiatric hospitalizations, suggesting this model may be more effective in managing mental health issues compared to blended FFS, but had no notable impact on follow-up visits within 14 days of discharge.
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In Canada's most populous province, Ontario, family physicians may choose between the blended fee-for-service (Family Health Group [FHG]) and blended capitation (Family Health Organization [FHO] payment models). Both models incentivize physicians to provide after-hours (AH) and comprehensive care, but FHO physicians receive a capitation payment per enrolled patient adjusted for age and sex, plus a reduced fee-for-service while FHG physicians are paid by fee-for-service. We develop a theoretical model of physician labor supply with multitasking to predict their behavior under FHG and FHO, and estimable equations are derived to test the predictions empirically.

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Article Synopsis
  • The study explores how family physicians in Ontario respond to financial incentives by analyzing data from 2003-2008, focusing on two payment models: traditional fee-for-service (FFS) and blended FFS (Family Health Group, FHG).
  • Researchers utilized advanced statistical methods to assess the effects of switching to FHG on service delivery, revealing that this transition leads to increases in comprehensive care (3%), after-hours services (15%), and non-incentivized services (4%) annually.
  • The findings suggest that while moving to FHG enhances access to after-hours care, the overall impact on increasing service production is limited, with physicians working more days, including holidays and weekends, but only modestly increasing the volume of services.
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