SARS-CoV-2 testing and COVID-19 related primary care use among people with citizenship, permanent residency, and temporary immigration status in British Columbia: Cross-sectional analysis of population-based administrative data

Wiedmeyer, Mei-Ling; Goldenberg, Shira M.; Peterson, Sandra; Wanigaratne, Susitha; Machado, Stefanie; Tayyar, Elmira; Braschel, Melissa; Carrillo, Ruth; Sierra-Heredia, Cecilia; Tuyisenge, Germaine; Lavergne, M. Ruth

doi:10.1101/2021.11.05.21265978

Cited by 2 publications

(2 citation statements)

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“…15,16 This changes the calculation to the remaining 3,400 doctors theoretically each caring for ∼1,618 patients each. This larger number poses a potential excessive work volume, which compounds the other major flaw of the calculation: the assumption that all actual needs of patients can be met by their family doctor, [17][18][19] that all family doctors will work the same hours and with the same set of skills, 16,20 and that practice infrastructure will work seamlessly without creating any extra work for physicians. 21,22 In fact, patients are not interchangeable units of work, neither are family physicians interchangeable workers.…”

Section: The Problemmentioning

confidence: 99%

“…Existing research tells us there is significant variation in patient needs 18,19,[23][24][25] and physician practice patterns. 16,20,26 For example, some doctors may work in neighbourhoods or with sub-populations whose needs are more complex and therefore each patient visit needs more time and/or resources, meaning fewer patients can be seen.…”

Section: The Problemmentioning

confidence: 99%

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What can publicly funded schools teach us about how to fix the family doctor shortage?

McCracken

Hedden

2023

Healthc Manage Forum

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Recent estimates suggest that up to 22% of Canadians over 18 do not have regular access to a family doctor or nurse practitioner. This lack of access is often characterized as a “family doctor shortage” and has been making headlines for decades. However, we have more family doctors than ever before, and in fact, the lack of primary care access is less about a shortage of physicians and more a need to develop a modern infrastructure and new way of funding and organizing care. Real change will require a paradigm shift from doctor- to clinic-organized care. The example of how schools are organized for public education may hold answers about how to make that paradigm shift and with investment in infrastructure see improvements in access to care across the country.

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Section: The Problemmentioning

confidence: 99%

Section: The Problemmentioning

confidence: 99%

What can publicly funded schools teach us about how to fix the family doctor shortage?

McCracken

Hedden

2023

Healthc Manage Forum

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COVID-19 among migrants, refugees, and internally displaced persons: systematic review, meta-analysis and qualitative synthesis of the global empirical literature

Hintermeier,

Gottlieb,

Rohleder

et al. 2023

Preprint

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SUMMARYBackgroundPandemic response and preparedness plans aim at mitigating the spread of infectious diseases and protecting public health, but migrants are often side-lined. Evidence amounted early that migrants are disproportionately affected by the COVID-19 pandemic and its consequences. However, synthesised evidence is lacking that quantifies the inequalities in infection risk and disease outcomes, or contextualises the consequences of pandemic measures and their underlying mechanisms.MethodsSystematic review searching 25 databases and grey literature (12/2019 to 11/2021). We considered empirical articles covering migrants, refugees, asylum-seekers, and internally displaced persons reporting SARS-CoV-2 cases, hospitalisation, ICU admission, mortality, COVID-19 vaccination rates or health consequences of pandemic measures. Random-effects meta-analysis of observational studies and qualitative analysis were performed for evidence synthesis. A Protocol was registered with PROSPERO (CRD42021296952).FindingsOut of 6956 studies, we included 241 in the review. For the quantitative studies (n=46), meta-analysis with over 40 million study participants showed that compared to non-migrants, migrants have an elevated risk of infection (RR = 2·33; 95%-CI: 1·88-2·89) but similar risk for hospitalisation (RR = 1·05; 0·80-1·37), while the likelihood of ICU admission was higher (RR = 1·36; 1·04-1·78). Among those hospitalised, migrants had a lower risk of mortality (RR = 0·47; 0·30-0·73), while their population-based excess mortality tended to be higher (RR = 1·31; 0·95-1·80). The qualitative synthesis (n=44) highlighted the complex interplay of social and COVID-19-related factors at different levels. This involved increased exposure, risk, and impact of pandemic measures that compromised the health of migrants.InterpretationEven in the advanced stages of the pandemic, migrants faced higher infection risks and disproportionately suffered from the consequences of COVID-19 disease, including deaths. Population-level interventions in future health emergencies must better consider socio-economic, structural and community-level exposures to mitigate risks among migrants and enhance health information systems, to close coverage gaps in migrant groups.FundingNone.

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SARS-CoV-2 testing and COVID-19 related primary care use among people with citizenship, permanent residency, and temporary immigration status in British Columbia: Cross-sectional analysis of population-based administrative data

Cited by 2 publications

References 26 publications

What can publicly funded schools teach us about how to fix the family doctor shortage?

What can publicly funded schools teach us about how to fix the family doctor shortage?

COVID-19 among migrants, refugees, and internally displaced persons: systematic review, meta-analysis and qualitative synthesis of the global empirical literature

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