Team-Based Care and Mental Health Service Provision: Evidence from Ontario

Abstract

This paper assesses the efficacy of team-based care, an increasingly popular mode of healthcare delivery. We study overall health outcomes as well as mental health, an area historically under-served by physicians. We use an event study approach that leverages rich administrative healthcare data from Canada’s most populous province, Ontario, and quasi-experimental variation associated with the introduction of the province-wide Family Health Team (FHT) policy. We find FHTs significantly improved overall primary care quality, reducing emergency room use by around 7% after four years. Concerning mental health care, we find evidence consistent with an adjustment in care provision: while early-wave FHTs substituted social workers for physicians, yielding no change in quality, later-wave FHTs saw significant quality improvements, with physicians and social workers collaborating. These findings indicate team-based care is not a fixed treatment: optimal outcomes are achieved when the deployment of interdisciplinary providers takes into account the degree of treatment substitutability.

Keywords: Health Service Provision, Mental Health Care, Team-Based Care, Primary Care Reforms, Physician Incentives, Health Production Function