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Variations in monetary distribution among Ontario’s Alternative Funding Agreement workload model hospitals

Published online by Cambridge University Press:  21 May 2015

Mitchell Whyne ,
Garrett Whyne  and
Brian H. Rowe
Mitchell Whyne*
Affiliation:
Emergency AFA Group, Royal Victoria Hospital, Barrie, Ont.
Garrett Whyne
Affiliation:
Emergency AFA Group, Royal Victoria Hospital, Barrie, Ont.
Brian H. Rowe
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, Alta.
*
Royal Victoria Hospital, 201 Georgian Dr., Barrie ON L4M 6M2

Abstract

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Objectives:

Alternative Funding Agreements (AFAs) were in place in 41 hospital emergency departments (EDs) in Ontario at the time of this survey (May to August 2005). Each of these 41 hospitals works with its own internal administrative model. The primary objective of this paper was to document the administrative models used in these Ontario EDs. The secondary objective was to inform current and future AFA EDs of the potential models.

Methods:

Telephone surveys were conducted with a member of each of the 41 AFA workload model hospitals.

Results:

All hospitals provided at least 1 emergency physician to answer the questionnaire. Although most AFA hospitals divide the AFA fund pool on an hourly basis, there is impressive variation on premium values awarded for day, evening, weekend and night shifts. Other variations included holdback of funds for bonuses, distribution of non-OHIP (Ontario Health Insurance Plan) dollars, on-call allowances, and different pay scales for the general practitioners and locums working in some departments.

Conclusions:

Allowing flexibility in distribution of AFA dollars to physicians in each group has helped make this program more acceptable. Many issues unrelated to funding remain to be resolved in order to stabilize ED recruitment and retention as well as improve work satisfaction. Further research on these latter topics is required to develop a fair and equitable funding arrangement that supports and enhances physician coverage in EDs across Canada.

Keywords

AFAAlternative Funding Agreementspremiumsnon-OHIP dollarsfast-track
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 9 , Issue 1 , January 2007 , pp. 21 - 25
Copyright
Copyright © Canadian Association of Emergency Physicians 2007

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