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Cited by 61Primary Care and Health OutcomesGlobal Health Workforce IssuesHealthcare Systems and Technology

Understanding the Unattached Population in Ontario: Evidence from the Primary Care Access Survey (PCAS)

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Hay, Carley, Pacey, Michael, Bains, Namrata, Ardal, Sten·2010·Healthcare Policy | Politiques de Santé
DOI 10.12927/hcpol.2010.22033PMC PMC3016634
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Abstract

To measure primary care access on an ongoing basis, the Ontario ministry of Health and Long-Term Care implemented the Primary Care Access survey (PCAs) in 2006.The PCAs, a cross-sectional telephone survey, samples approximately 8,400 Ontario adults each year.It collects information on access to a family doctor, use of services, health status and socio-demographics.Analysis of the 2007-2008 PCAs (n=16,560) shows that 7.1% of Ontario' s adults were without a family doctor (i.e., unattached).The attached and unattached populations differed on socio-demographic and health characteristics.Emergency department use was similar between the two groups, but walk-in clinic use was higher among the unattached.The unattached were less likely to have used care for immediate issues but accessed care in a more timely fashion than the attached.This initial exploration of the PCAs provides a better understanding of some of the differences between the attached and unattached populations in Ontario. RésuméEn 2006, le ministère ontarien de la santé et des soins de longue durée mettait en place le sondage sur l' accès aux soins primaires (Primary Care Access survey, ou PCAs) pour mesurer de façon continue l' accès à ce type de soins.Le PCAs est une enquête téléphonique transversale dont l' échantillon annuel est d' environ 8 400 Ontariens adultes.Elle permet de recueillir des renseignements sur l' accès au médecin de famille, l'utilisation des services, l' état de santé et la situation sociodémographique.L' analyse des données du PCAs de 2007-2008 (n=16 560) montre que 7,1 % des Ontariens adultes n' ont pas de médecin de famille.Les populations avec et sans médecin de famille présentent différentes caractéristiques sociodémographiques et sanitaires.L'utilisation du service des urgences est semblable entre les deux groupes,

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  • Patients without a regular primary care provider often experience access barriers, lower continuity of care, less comprehensive care, a lack of care coordination, more unmet needs, and often rely on walk-in clinics and emergency departments.

    “Conversely, patients without a regular primary care provider often experience access barriers, lower continuity of care, less comprehensive care, a lack of care coordination, more unmet needs, and often rely on walk-in clinics and emergency departments, where care can be suboptimal, particularly for patients with complex needs [2, 7, 18–21].”

    From Improved access to and continuity of primary care after attachment to a family physician: longitudinal cohort study on centralized waiting lists for unattached patients in Quebec, Canada (2022) · cites this paper as [7]

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  • Patients without a regular provider often avoid health care, have unmet needs, face difficulties accessing preventive care, and accumulate health problems.

    “Patients without a regular provider often avoid health care, have unmet needs, face difficulties accessing preventive care, and accumulate health problems [2, 7, 18–20, 73].”

    From Improved access to and continuity of primary care after attachment to a family physician: longitudinal cohort study on centralized waiting lists for unattached patients in Quebec, Canada (2022) · cites this paper as [7]

    The Results report that Ontarians without a family doctor used routine care less often, and the Discussion and Conclusion cites a previous study reporting more difficulty accessing routine care. But this paper did not assess access difficulties directly; it says lower use might reflect less perceived need, limited access, or both. It does not establish deliberate avoidance, unmet needs, difficulty accessing preventive care specifically, or accumulating health problems; it describes the unattached group as younger and healthier. (LLM, conf=0.88)

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  • Patients who have a regular provider use more primary care services than patients without a family physician, suggesting better access to primary care.

    “Patients who have a regular provider use more primary care services, suggesting better access to primary care than patients without a family physician [7–10].”

    From Improved access to and continuity of primary care after attachment to a family physician: longitudinal cohort study on centralized waiting lists for unattached patients in Quebec, Canada (2022) · cites this paper as [7]

    The Results report greater use of overall, routine, and immediate care among Ontarians with a family doctor. But the Discussion and Conclusion say lower routine-care use among those without one may reflect less need, less access, or both; those without a family doctor also received urgent care more promptly when they sought it. Greater use is supported, but the inference of generally better access is not established. (LLM, conf=0.85)

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  • Previous studies comparing patients with and without a regular family physician may be biased because these groups have different characteristics.

    “Previous studies compare patients with and without a regular family physician, but these groups have different characteristics that may influence and bias results [5, 7, 10, 19, 22–26].”

    From Improved access to and continuity of primary care after attachment to a family physician: longitudinal cohort study on centralized waiting lists for unattached patients in Quebec, Canada (2022) · cites this paper as [7]

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Research works printed but not linked: 4

  1. Chaix, B., P.J. veugelers, P.-Y. Boelle and P. Chauvin. 2005. "Access to General Practitioner services: The disabled Elderly Lag Behind in underserviced Areas." European Journal of Public Health 15(3): 282-87.
  2. devoe, J.E., G.E. fryer, R. Phillips and L. Green. 2003. "Receipt of Preventative Care among Adults: Insurance status and usual source of Care." American Journal of Public Health 93: 786-91.
  3. Ontario Health quality Council. 2009. Q Monitor: 2009 Report on Ontario's Health System (Chapter 2). Retrieved October 8, 2010. <http://www.ohqc.ca/pdfs/ohqc_2009_report_-_eng- lish.pdf>.
  4. sanmartin, C., J.m. Berthelot, E. Ng, K. murphy, d.L. Blackwell, J.f. Gentlemen, m.E. martinez and C.m. simile. 2006. "Comparing Health and Health Care in Canada and the united states." Health Affairs 25(4): 1133-42.

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Authors
Hay, C., Pacey, M., Bains, N., & Ardal, S.
Affiliations
Ministry of Health and Long Term Care (CA)
Venue
Healthcare Policy | Politiques de Santé
Publisher
Longwoods Publishing
Published
2010-11-10
Volume
6
Issue
3
Pages
33-47
ISSN
  • 1715-6572 (ISSN-L)
  • 1715-6580
DOI
10.12927/hcpol.2010.22033
PMC
PMC3016634
OpenAlex
W2039791604
Cited by
61
References
27
Citations by year
2026: 1 · 2025: 2 · 2024: 5 · 2023: 10 · 2022: 11 · 2021: 11 · 2020: 2 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 3 · 2012: 3
FWCI
2.28
Type
journal article
Language
en
Open access
Locations
  • Healthcare policy (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
Keywords
primary care access, general practitioners, emergency department utilization, health care utilization, sociodemographic differences, health status, Ontario

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