Income and Regional Gradients in Being without a Regular Doctor: Does the Slope of Gradients Decrease for Those with Greater Health Needs?

Sepehri, Ardeshir

doi:10.12927/hcpol.2014.23783

Cited by 1 publication

(1 citation statement)

References 19 publications

(27 reference statements)

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“…For team-based primary care physician access, we found that immigrants, refugees, and people residing in urban areas were substantially less likely to have access to team-based primary care. Similar gaps in primary care access have been consistently documented in the general population, in Canada and internationally (Exworthy et al, 2006;Glazier, Zagorski, & Rayner, 2012;Hay et al, 2010;Reid et al, 2009;Sepehri, 2014;Ssendikaddiwa et al, 2023;Talbot et al, 2001;Viera et al, 2006). Reasons behind these disparities are likely multifactorial but may be influenced by Ontario's primary care payment system.…”

Section: Discussionmentioning

confidence: 65%

Access to a regular primary care physician among young people with early psychosis in Ontario, Canada

Rodrigues,

Reid,

Wiener

et al. 2023

Early Intervention Psych

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AimAccess to a primary care physician in early psychosis facilitates help‐seeking and engagement with psychiatric treatment. We examined access to a regular primary care physician in people with early psychosis, compared to the general population, and explored factors associated with access.MethodsUsing linked health administrative data from Ontario (Canada), we identified people aged 14–35 years with a first diagnosis of nonaffective psychotic disorder (n = 39 449; 2005–2015). We matched cases to four randomly selected general population controls based on age, sex, neighbourhood, and index date (n = 157 796). We used modified Poisson regression to estimate prevalence ratios (PR) for access to a regular primary care physician in the year prior to first diagnosis of psychotic disorder, and the sociodemographic and clinical factors associated with access.ResultsA larger proportion of people with early psychosis had a regular primary care physician, relative to the general population (89% vs. 68%; PR = 1.30, 95%CI = 1.30–1.31). However, this was accounted for by a higher prevalence of comorbidities among people with psychosis, and this association was no longer present after adjustment (PR = 0.97, 95%CI = 0.97, 0.98). People with early psychosis who were older, male, refugees and those residing in lower income or high residential instability neighbourhoods were less likely to have a regular primary care physician.ConclusionApproximately one in ten young people with early psychosis in Ontario lack access to a regular primary care physician. Strategies to improve primary care physician access are needed for management of physical comorbidities and to ensure continuity of care.

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