Summary:

The OurCare project conducted one of the largest nation-wide surveys on primary health care in Canada and found that Canadians' access to primary care is worse than previously thought. Only 77% of respondents reported having a family doctor or nurse practitioner, lower than pre-pandemic estimates. Timely access to care was highlighted as a key issue, with many individuals relying on walk-in clinics. Certain demographics, such as young adults, lower income groups, and racialized people, had even less access to primary care support. The survey also emphasized the importance of relationships in primary care, with respondents prioritizing being viewed as a complete person by their healthcare providers. However, there were concerns about virtual care, including its potential connection to pharmaceutical companies and data privacy. The OurCare project will continue with in-depth reviews of primary care in Ontario and the formation of local community round tables to address the unique needs of underserved communities.

Takeaways:

🔍 Canadians' access to primary care is lower than previously estimated, with only 77% having a family doctor or nurse practitioner.

👥 Timely access to care is a key issue, with many individuals relying on walk-in clinics.

🌍 Certain demographics, such as young adults, lower income groups, and racialized people, have even less access to primary care support.

💙 Relationships with healthcare providers are important to patients and prioritized over timely access to care.

💻 Concerns exist about virtual care services, including potential ties to pharmaceutical companies and data privacy.

🔬 The OurCare project will continue with in-depth reviews of primary care in Ontario and address the unique needs of underserved communities through local community round tables.

Canadians’ access to primary care is worse than previously thought

According to results of the first phase of the OurCare project, one of the largest ever nation-wide surveys on primary health care, Canadians' access to primary care is worse than previously thought. Of the nearly 9,300 survey respondents, only 77 per cent reported having a family doctor or nurse practitioner. Pre-pandemic estimates had put this number closer to 85 per cent.

Survey data have been compiled into an interactive online dashboard. The survey results mark the end of the first of three phases of the OurCare project, which aims to find the gaps and possible solutions to some of the biggest issues in primary care in Canada. The project was conceived in June 2021 as a collaboration between Tara Kiran, a family doctor and scientist with MAP Centre for Urban Health Solutions, and colleague Peter MacLeod with MASS LBP. Plans were finalized with buy-in from provincial and national health-care partners, stakeholders, and the public through the Canadian Medical Association’s group, Patient Voice.

Key Findings

Questions covered topics ranging from timeliness and proximity to care, relationships with caregivers, and willingness to receive care from a health team.

• Timely access to care was highlighted as a key issue. Walk-in clinics were used by nearly half of respondents in the past year, with one-third citing walk-in clinics as the only places they could get care.
• Certain demographics have even less access to primary care support. Young adults, lower income groups, and racialized people were all even less likely to have a family doctor.
• Access by region was the most prominent determinant of connection with a family doctor. Only 69 to 71 per cent of respondents in B.C., Quebec, and the Atlantic provinces had access to a family doctor, compared with 86 and 82 per cent in Ontario and the Prairies, including Manitoba, Saskatchewan, and Alberta, respectively.

More than 9,200 people completed the survey, which ran from September to October last year. The responses were then weighted to reflect Canadian demographics based on recent census data.

Importance of Relationships in Primary Care

Kiran says that Canadians are open to doing things differently if it means they and their neighbors will ultimately receive better access to care. About 90 per cent said they would be comfortable getting support from another health team member if their doctor recommended it.

“Relationships are important – even more important than timely access to care.”

She says she was heartened to see what respondents highlighted as one of their top priorities. “Patients want to be viewed as a complete person by their health-care providers,” says Kiran. “Relationships are important – even more important than timely access to care. We know that relationships are really at the heart of good primary care, and now all of the evidence actually lines up to say that.”

Concerns About Virtual Care

Some health-care reforms don’t sit well with the public. “We asked how willing you would be to use virtual-care services if the company that ran the service was receiving payments or was owned by a pharmaceutical company.” The response: 70 per cent answered “not very willing” or “not willing at all” to receive care if that was the case.

Canadians are also leery of virtual-care services selling their data; 84 per cent said they would not use virtual care if the company sells data about their health, even if identifying information were removed. “I think it just speaks to the importance of people knowing clearly how their data will be used upfront before they decide to use that service,” Kiran says.

Next Steps of the OurCare Project

The next step of the OurCare project involves a more in-depth review of Ontario’s primary care. A group of 36 volunteers from outside the medical community, who are representative of the demographic distributions of the province, have been chosen to take part in sessions to learn the details of the primary care system.

The group has already begun meeting to cover topics such as different primary-care models, health systems, equity, and access. “I think this is going to challenge experts and really help us continue to talk about the values that underlie the future primary-care system,” says Kiran. The panelists will spend more than 30 hours learning about primary care from different experts and perspectives.

After the group has been primed with all the information, it will meet in-person in February to discuss possible solutions. “This is a really exciting step that I think is going to help us go deeper than we could with the survey.” On Feb. 12, the group will present its final recommendations. Matthew Anderson, CEO of Ontario Health, is among the health-system leaders who will attend.

The third and final phase of the project will assemble local community round tables made up of volunteers from marginalized backgrounds who will focus on the unique needs of underserved communities. The local community round tables are expected to meet in the spring.

Visit data.ourcare.ca to explore the results of the OurCare national research survey.