Disparities in health outcomes among seniors without a family physician in the North West Local Health Integration Network: a retrospective cohort study

Abstract

hile access to family physicians is of concern to many Ontarians, 1,2 this issue is particularly salient to residents of the North West Local Health Integration Network. The multiple health benefits of having a family physician are well documented. For example, people who have a family physician have lower rates of emergency department use 3 and are more likely to report that they received routine monitoring of health issues or check-ups. 2 Yet, an estimated 16.2% of residents in this health region do not have a family physician; by comparison, 6.2% of residents across the entire province lack a family physician. 4 Further, only 23.8% of residents in the North West Local Health Integration Network indicated that they accessed primary care within 48 hours of illness, whereas 43.6% of Ontarians said they did. 4 The vast geography of the area served by this network also poses access challenges. Although 46.0% of the North West Local Health Integration Network's residents live in Thunder Bay, 34.2% live in rural areas and 19.8% live in small-and medium-sized population centres scattered across 47% of Ontario's land mass. 4 Consequently, some people need to travel hundreds of kilometres by land, water and air to access health care services. 4 Even more troubling is the fact that between February 2009 and March 2017, of the 1325 people with high health care needs who did not have a family physician and were registered with Health Care Connect (an Ontario Ministry of Health and Long-Term Care program designed to help Ontarians without a primary health care provider find one 5 ),

Age- and sex-specific associations of frailty with mortality and healthcare utilization in community-dwelling adults from Ontario, Canada

“…Second, overall healthcare service utilization, which includes consultation with a family physician [ 29 ], increases with age [ 30 ] and access to government supported preventative health programs tends to become available around the age of retirement. Regular access to a family physician alone reduces the need for acute or urgent hospital care [ 31 ] or the risk of catastrophic health outcomes [ 32 ] and would be expected to reduce the impact of frailty on health outcomes as well. Lastly, given that the effect of frailty on health outcomes likely plateaus with increasing magnitude [ 8 , 33 ], one would expect hazard estimates in groups with relatively lower levels of frailty (i.e.…”

Pneumococcal vaccination uptake and missed opportunities for vaccination among Canadian adults: A cross-sectional analysis of the Canadian Longitudinal Study on Aging (CLSA)

“…Moreover, previous research has shown that knowledge of and ability to deliver key vaccinations likely varies across providers and settings and may thus contribute to non-vaccination among high-risk populations [37,38]. It is also worth highlighting that roughly 15% of Canadians do not have a regular healthcare provider and can only count on walk-in clinics that, however, do not offer the same degree of continuity of care that might improve the provider-patient relationship and favor the implementation of preventative actions such as immunizations [39,40]. Examining MOV requires further investigation to better understand the reasons why vaccination was not offered and/or administered to someone eligible, which could suggest opportunities for designing and testing interventions at the provider, patient, community, or healthcare system level to increase uptake.…”

Evaluation of the implementation of single points of access for unattached patients in primary care and their effects: a study protocol

“…It leads to reduced prevention and health promotion services and to deleterious health effects such as higher mortality rates, increased risks of adverse health outcomes, poorer chronic disease management and delays in obtaining care. Lack of access also contributes to non-optimal use of resources, such as higher utilisation of the emergency department for non-urgent conditions, potentially avoidable hospitalisations and higher costs for the healthcare system 5 7–16…”