The impact of not having a primary care physician among people with chronic conditions

Glazier RH, Moineddin, R, Agha MM, Zagorski B, Hall R, Manuel DG, Sibley LM, Kopp A
Record ID 32011000211
English
Authors' objectives:

The purpose of this study was to examine specifi c health system impacts related to Ontarians with chronic health conditions who did not have a primary care physician at the time they were surveyed. Data from Cycle 1.1 of the Canadian Community Health Survey (CCHS) from 2000–01 were obtained and analyzed, along with a 20% random sample of Ontario’s population (2003–05). This information was then linked to data on health care use in Ontario in 2005–06.

Authors' recommendations: Our analyses of data on Ontarians with chronic health conditions demonstrate that the majority of these people— 90 to 95 percent—reported having a regular medical doctor at the time they were surveyed. The patterns of care we observed in this group suggest they experienced few serious access barriers to primary care.However, among the remaining minority of people with chronic conditions, we were able to link three specifi c patient groups with potentially avoidable and costly demands on the health care system. These included thousands of excess ED visits and thousands of excess medical non-elective hospital admissions. Such potentially avoidable ED visits and hospital admissions contribute to the crowding of EDs and to hospital bed shortages. They are also highly likely to be associated with preventable suffering and clinical deterioration which can sometimes be irreversible.We believe that all three patient groups—those who did not have a regular medical doctor; those whose records showed relatively few physician visits in the previous two years; and those whose pattern of health system usage suggested low continuity of care—represent Ontarians with chronic illness who are having trouble accessing primary care.We also believe that, given these impacts on health services and on people, implementing policies to address the current shortage of primary health care physicians in Ontario should be seen as a top health system priority.
Details
Project Status: Completed
Year Published: 2008
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Physicians, Primary Care
Contact
Organisation Name: Institute for Clinical Evaluative Sciences
Contact Address: Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, G-Wing, Toronto ON, Canada, M5N 3M5. Tel: 416-480-4055; Fax: 416-480-6048
Contact Name: info@ices.on.ca
Contact Email: info@ices.on.ca
Copyright: Institute for Clinical Evaluative Sciences (ICES)
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