Association between patient attachment to a regular doctor and self‐perceived unmet health care needs in Canada: A population‐based analysis of the 2013 to 2014 Canadian community health surveys

Awe, Oluwakemi A.; Okpalauwaekwe, Udoka; Lawal, Adegboyega; Ilesanmi, Marcus M.; Feng, Cindy; Farag, Marwa

doi:10.1002/hpm.2632

“…While participants were creative in their efforts to obtain interim care, it was clear that many still had healthcare needs that went unmet. Indeed, not having a regular PHC provider is a significant and strong predictor of having unmet healthcare needs [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…In Canada, primary care is the first line of contact with the healthcare system, through which patients access diagnostics and further specialist care. For patients, attachment is related to more timely treatment [ 3 ], better preventive care and chronic disease management [ 4 , 5 ], lower likelihood of unmet health needs [ 6 , 7 ], and ultimately, better health outcomes [ 1 , 2 ]. However, some populations face challenges to accessing care and experience lower attachment rates [ 7 ], such as recent immigrants [ 8 ], LGBTQ + populations [ 9 ], and those experiencing homelessness [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“What do you mean I can’t have a doctor? this is Canada!” – a qualitative study of the myriad consequences for unattached patients awaiting primary care attachment

Marshall

¹

,

Wuite

²

,

Lawson

³

et al. 2022

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Background Patient access to primary healthcare (PHC) is the foundation of a strong healthcare system and healthy populations. Attachment to a regular PHC provider, a key to healthcare access, has seen a decline in some jurisdictions. This study explored the consequences of unattachment from a patient perspective, an under-studied phenomenon to date. Methods A realist-informed qualitative study was conducted with unattached patients in Nova Scotia, Canada. Semi-structured interviews with nine participants were conducted and transcribed for analysis. The framework method was used to carry out analysis, which was guided by Donabedian’s model of assessing healthcare access and quality. Results Five key findings were noted in this study: 1) Participants experienced a range of consequences from not having a regular PHC provider. Participants used creative strategies to 2) attempt to gain attachment to a regular PHC provider, and, to 3) address their health needs in the absence of a regular PHC provider. 4) Participants experienced negative feelings about themselves and the healthcare system, and 5) stress related to the consequences and added work of being unattached and lost care. Conclusions Unattached patients experienced a burden of care related to lost care and managing their own health and related information, due to the download of medical record management and system navigation to them. These findings may underestimate the consequences for further at-risk populations who would not have been included in our recruitment. This may result in poorer health outcomes, which could be mitigated by interventions at the structural level, such as enhanced centralized waitlists to promote attachment. Such waitlists may benefit from a triage approach to appropriately attach patients based on need.

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“…While participants were creative in their efforts to obtain interim care, it was clear that many still had healthcare needs that went unmet. Indeed, not having a regular PHC provider is a signi cant and strong predictor of having unmet healthcare needs (7).…”

Section: Discussionmentioning

confidence: 99%

“…For patients, attachment is related to more timely treatment (3), better preventive care and chronic disease management (4,5), lower likelihood of unmet health needs (6, 7), and ultimately, better health outcomes (1,2). However, some populations face challenges to accessing care and experience lower attachment rates (7), such as recent immigrants (8), LGBTQ + populations (9), and those experiencing homelessness (10).…”

Section: Introductionmentioning

confidence: 99%

“What Do You Mean I Can't Have a Doctor? This is Canada!” – A Qualitative Study of the Myriad Consequences for Unattached Patients Awaiting Primary Care Attachment

Marshall

¹

,

Wuite

²

,

Lawson

³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background Patient access to primary healthcare (PHC) is the foundation of a strong healthcare system and healthy populations. Attachment to a regular PHC provider, a key to healthcare access, has seen a decline in some jurisdictions. This study explored the consequences of unattachment from a patient perspective, an under-studied phenomenon to date. Methods A realist-informed qualitative study was conducted with unattached patients in Nova Scotia, Canada. Semi-structured interviews with nine participants were conducted and transcribed for analysis. The framework method was used to carry out analysis, which was guided by Donabedian’s model of assessing healthcare access and quality. Results Five key findings were noted in this study: 1) Participants experienced a range of consequences from not having a regular PHC provider. Participants used creative strategies to 2) attempt to gain attachment to a regular PHC provider, and, to 3) address their health needs in the absence of a regular PHC provider. 4) Participants experienced negative feelings about themselves and the healthcare system, and 5) stress related to the consequences and added work of being unattached and lost care. Conclusions Unattached patients experienced a burden of care related to lost care and managing their own health and related information, due to the download of medical record management and system navigation to them. These findings may underestimate the consequences for further at-risk populations who would not have been included in our recruitment. This may result in poorer health outcomes, which could be mitigated by interventions at the structural level, such as enhanced centralized waitlists to promote attachment. Such waitlists may benefit from a triage approach to appropriately attach patients based on need.

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“…16,19,22 However, the three territories (Northwest Territories, Nunavut and Yukon) have received limited focus in earlier researches that have examined provincial variations in unmet healthcare needs among Canadians. Furthermore, while there is evidence that not having a regular medical doctor triggers unmet healthcare needs among people, 23 less is known about provincial variations in the effect of not having a regular medical doctor on unmet healthcare needs among Canadians.…”

Section: Highlightsmentioning

confidence: 99%

Provincial variations in not having a regular medical doctor and having unmet healthcare needs among Canadians

Islam

¹

,

Kellett

²

2022

Health Planning & Management

1

0

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Background: Despite spending 11.0% of the total gross domestic product, the quality of healthcare services in Canada has received mixed reviews. We first separately examined provincial variations in not having a regular medical doctor and having unmet healthcare needs among Canadians.Second, we evaluated provincial variations in the impact of not having a regular medical doctor on having unmet healthcare needs among Canadians.Methods: We applied logistic regressions using data from

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Association between patient attachment to a regular doctor and self‐perceived unmet health care needs in Canada: A population‐based analysis of the 2013 to 2014 Canadian community health surveys

Abstract: Ongoing public discourses on improving primary health care performance and reducing the burden of UHN in Canada should prioritize efforts that promote and facilitate the use of a regular family physician.

Cited by 13 publications

References 31 publications

“What do you mean I can’t have a doctor? this is Canada!” – a qualitative study of the myriad consequences for unattached patients awaiting primary care attachment

“What do you mean I can’t have a doctor? this is Canada!” – a qualitative study of the myriad consequences for unattached patients awaiting primary care attachment

“What Do You Mean I Can't Have a Doctor? This is Canada!” – A Qualitative Study of the Myriad Consequences for Unattached Patients Awaiting Primary Care Attachment

Provincial variations in not having a regular medical doctor and having unmet healthcare needs among Canadians

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