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

51 Pages Posted: 3 Feb 2022

See all articles by Elaine Guo

Elaine Guo

University of Toronto - Department of Economics

Claire de Oliveira

University of York


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

Suggested Citation

Guo, Elaine and de Oliveira, Claire, Team-Based Care and Mental Health Service Provision: Evidence from Ontario. Available at SSRN: or

Elaine Guo (Contact Author)

University of Toronto - Department of Economics ( email )

150 St. George Street
Toronto, Ontario M5S3G7
9059216689 (Phone)

Claire De Oliveira

University of York ( email )

University of York
York, YO10 5DD
United Kingdom

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