The Effect of Rostering with a Patient Enrolment Model on Emergency Department Utilization

Objective: To assess the effect of rostering with a patient enrolment model (PEM) in Ontario on emergency department utilization for non-emergent care. Data sources/study setting: Administrative data for fiscal years 2006/07 through 2010/11 from the Ontario Ministry of Health and Long-Term Care were used for the analysis. Study design: Patient-level analysis with a difference-in-difference modelling approach was used to study the relationship. A control group was established using propensity score matching. Principal finding: Results suggest that rostering with a PEM is associated with a statistically significant reduction in emergency department (ED) (non-emergent) visits in Ontario. More specifically, enrolment with PEMs reduced ED visits by 3% during the study period, translating into cost savings of approximately $8 million for hospitals in Ontario. Conclusion: This study shows that PEMs have achieved some degree of success in enhancing health system efficiency in Ontario through the reduction in the use of EDs for non-emergent care.