Measuring and publicly reporting on the performance of primary care in Ontario helps to improve health outcomes of patients. Indicators measuring the performance of primary care were last reviewed in 2015.
Find out about how the approach to measuring primary care was developed in the report, A Primary Care Performance Measurement Framework for Ontario, which outlines 299 indicators at the system and practice level.
View an overview of the Primary Care Performance Measurement Framework in a one-page chart.
Learn about the subset of high-priority quality indicators that could advance quality in primary care in The Primary Care Performance Measurement: Priority Measures for System and Practice Levels report.
If you have a question about primary care quality indicators, please email us at firstname.lastname@example.org.
Data for some indicators is provided by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care. The opinions, results and conclusions reported here are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario Ministry of Health and Long-Term Care is intended or should be inferred. The datasets for some indicators were linked using unique encoded identifiers and analyzed at ICES.
Discharge Abstract Database (DAD)
DAD is maintained by the Canadian Institute of Health Information (CIHI) and houses information on patients treated in acute care hospitals. Every time a patient is discharged from an acute care bed, the hospital submits an electronic record to CIHI that contains the patient’s demographic information as well as diagnostic and treatment data for that hospital admission.
Health Care Experience Survey (HCES)
The HCES is a voluntary telephone survey of people living in Ontario aged 16 and older. The survey asks randomly selected Ontarians for their views about their health care system, how healthy they are, what health conditions they have, their use and experience with the health care system including primary and specialty care, if they have been to a walk-in clinic or hospital (including emergency department use), and their household and demographic characteristics.
Laboratory Reporting Tool (LRT)
The LRT includes data on fecal occult blood testing kit distribution, dispensing, and results from Colon Cancer Check-participating laboratories, including a unique physician identifier of the ordering physician. Data are available on Colon Cancer Check fecal occult blood testing kits processed from April 2008 onwards.
Colonoscopy Interim Reporting Tool (CIRT)
The CIRT is an easy-to-use, secure web-based tool that uploads colonoscopy information from hospitals to the program. It has been built for the colorectal cancer screening program, and it is similar to the Wait Times Interim Reporting Tool. CIRT is an interim tool and enables the capture of required information.
National Ambulatory Care Reporting System (NACRS)
NACRS is maintained by CIHI and contains data for hospital- and community-based emergency department and ambulatory care (e.g., day surgery, outpatient clinics). CIHI receives data directly from participating facilities or from their respective regional health authorities or the ministry.
Ontario Diabetes Database (ODD)
The ODD uses a validated method to identify people with diabetes using data on hospital stays and physician visits. Records from the DAD, collected by CIHI were used to identify Ontarians with a valid health card number who had been hospitalized with a new or pre-existing diagnosis of diabetes. Physician claim records held by the Ontario Health Insurance Plan (OHIP) were also used to identify individuals with visits to a physician for diabetes. Cases of diabetes related to pregnancy are excluded from the ODD. Individuals were considered to have diabetes if they had at least one hospitalization or two physician service claims over a two-year period that are diabetes-related. People are included in the ODD as new cases when they are first identified as having diabetes in the previously mentioned databases.
Ontario Health Insurance Plan (OHIP)
The OHIP claims database covers all reimbursement claims to the Ministry of Health and Long-Term Care made by fee-for-service physicians, community-based laboratories and radiology facilities. The OHIP database contains encrypted patient and physician identifiers, codes for services provided, date of service, the associated diagnosis and fee paid. OHIP claims are missing some services, such as services received in provincial psychiatric hospitals and diagnostic procedures performed on an inpatient basis. OHIP also excludes services provided by physicians who are on alternative funding plans, which may impact the results of the analysis.
Registered Persons Data Base (RPDB)
RPDB provides basic demographic information about anyone who has ever received an Ontario health card number. This database is maintained by the Ministry of Health and Long-Term Care and used and enriched by ICES with information from other data sets.
When interpreting and comparing the results of quality indicators in different populations, regions or over time, it is important to account for the underlying differences in the populations being compared. We call this “risk adjustment” and it allows us to make a fair comparison across groups and to distinguish variation that is due to differences in practice. Results can be adjusted to account for differences in the age, sex, or other characteristics of people within a certain population. Characteristics such as age can significantly affect people’s health status and their need for health services. By accounting for differences in age, health status and other factors, data can be risk-adjusted so that quality indicators are comparable across the province and over time.
Find more details about how we define the demographics that we monitor.
Age of a person (or the age range of groups) on the date (or period) relevant to the point of measurement. It is determined based on demographic information available in the existing administrative databases or information provided by the survey respondent.
Sex of a person - male or female - is determined based on demographic information available in the existing databases or information entered by the interviewer during the survey.
Average neighbourhood income (quintiles) is a proxy for a personal or household income level, calculated by Statistics Canada when new census data become available. Average income estimates are first calculated for small geographic areas that have a population of 400–700 people. Based on these estimates, Ontario neighbourhoods are classified into five equal-sized groups, or quintiles, from poorest (Q1) to wealthiest (Q5). The postal codes of a person's place of residence is used to assign them to one of the small geographic areas and then into one of the income quintiles.
Household income categories are defined based on income information provided by survey respondents. Income is reported in categories or in quintiles. Income categories provide information on a person's or household's absolute income. Income quintiles are calculated by Statistics Canada and provide an estimate of an individual's or family's income (based on household and community size) compared to other respondents in the same province.
The level of education is assigned based on the education information provided by survey respondents. The variable indicates the highest level of education acquired by the respondent. This analysis is available only for survey-based indicators.
Rural residence is a measure of community size and is assigned based on the postal code of a person's residence. Communities with a population of less than 10,000 people are defined as rural. Some data providers will also incorporate information on density or distance to urban areas to provide additional measures on the remoteness of the area.
The postal code of a person's place of residence is used to assign them to a Local Health Integration Network. For some indicators the postal codes of hospitals or location of service are used to assign LHIN rather than the patient's residence. In these cases, it will be noted for the indicator.
Immigration status is determined based on information provided by survey respondents or from information available in existing admin databases (Citizenship and Immigration database (CIC) or using the recent OHIP registrants as proxy from Ontario Health Insurance Plan Claims Database.