Strengths and Limitations
Limitations of the study include an inability to capture expenses related to care accessed outside of Ontario, the lack of consent to the use of health administrative data by some participants, and the lack of information on out-of-pocket expenses. Randomization was stratified by site but, due to an administrative issue related to data sharing, we did not adjust the results for site and, thus, any randomization imbalances within sites that occurred despite stratification could account for observed differences between groups, though there were no statistically significant differences between sites overall. Similarly, we did not adjust the analysis for socioeconomic or clinical factors. This randomized clinical trial of an intervention has clear policy implications, and it provides information about total health care costs using routinely collected administrative data.