Evaluating Ontario’s primary care reforms

In Progress

Access to Health Care


Primary care plays an important role in preventing disease, keeping populations healthy and is the first point of contact to the health care system for many Ontarians.

Drs. Tara Kiran and Rick Glazier’s joint research program is focused on improving how we deliver primary care in Ontario. They conduct patient-centered research to understand how government policies affect the quality of primary care and how primary care can be made better and more inclusive. Our research team uses administrative data collected by the provincial government to study the health care system in Ontario.

Over the last twenty years, the government introduced many primary care reforms including changes in how doctors were paid and organized. Our research aims to understand how these reforms have impacted the quality of care that patients receive. More recently, we have explored variation in timely access and continuity, two key tenets of primary care. Current work is focusing on changes in how we deliver care due to COVID-19.

We hope our research informs policy-makers, clinicians, and patients on what reforms are needed to further improve our primary care system.

Research Findings

Over the last decade, our research has highlighted many shortcomings in the current system including the following:

We have also highlighted strengths of our current system:

Peer Reviewed

Non-peer Reviewed

  • Glazier R, Kiran T. Doctors and Canadian Medicare: Improving System Performance Requires System Change. Healthcare Papers September 2018 17 (4): 41-47
  • Kiran T. Toward evidence-based policy. Canadian Medical Association Journal. August 15, 2016 188(15): 1065-1066
  • Glazier R, Kiran T, Ellison P, Zerger S, Matheson F, Gozdyra P, Becker H, O’Campo P. Examining the Consequences of Being Underserved in Primary Care: A Population-Based Approach in Ontario, Canada. Toronto: Institute for Clinical Evaluative Sciences and the Centre for Research on Inner City Health; March, 2016
  • Glazier RH, Kopp A, Schultz SE, Kiran T, Henry D. All the Right Intentions but Few of the Desired Results: Lessons on Access to Primary Care from Ontario’s Patient Enrolment Models. Healthcare Quarterly, 15(3) 2012: 17-21

Relevant Publications

Access to Health Care


Dr. Rick Glazier

A family doctor and leader in his field, Dr. Rick Glazier investigates primary care through a health-equity lens: revealing gaps in care, and examining the implications of primary-care reform for traditionally under-served groups. He is an expert in linking geographic methods with administrative health data to help identify priority areas for services and care.

Dr. Tara Kiran

A family doctor and renowned primary-care researcher, Dr. Tara Kiran investigates how changes in the health-care system impact the most vulnerable in society. In her research and practice, she develops and tests solutions to make health care more inclusive - and more effective.



  • Lidija Latifovic


  • University of Toronto Fidani Chair in Improvement and Innovation
  • Canadian Institutes for Health Research (CIHR)
  • Primary Health Care as the Foundation for Health Systems Performance, Integration and Sustainability: INSPIRE-PHC-2 Health System Research Fund Program Award