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In children age 2 to 9, 26% of visits to the emergency department were for conditions that could potentially be managed in primary care — higher than in other age groups. Similar trends exist in the subset of conditions that may be helped by virtual primary care. 

These findings suggest that parents of young children may face barriers in getting timely access to care for those children. This aligns with previous research showing that parents seek care in emergency departments for children’s minor medical conditions when barriers exist to timely primary care access.Reference1 Reference2

For older patients, there is a slight trend downward in the proportion of ED visits for conditions that could potentially be managed in primary care. Older adults are more likely to have a regular health care provider than younger adults.Reference3 Therefore, older adults may be more likely to have their primary health care needs addressed by a regular provider.

Rural and remote areas have more than twice the proportion of ED visits for conditions that could be managed in primary care than urban areas do. 24% of ED visits in rural and remote areas are for such conditions, compared with 11% in urban areas.

A similar trend exists for conditions that could be managed virtually. 13% of ED visits in rural and remote areas are for conditions that could potentially be managed in virtual primary care. In urban areas, that figure is 7%.

Patients in rural areas have less access to health care, including primary health care.Reference4 This may explain the trends in these findings.

Trend differences may also be due to primary care infrastructure. In rural or remote areas, a person’s primary care clinician may also be the emergency department physician, so the ED may be the place where people regularly access their primary care. Or, in some areas, the ED may be the only place to access care. 

In some provinces and territories, patients registering at the emergency department are asked whether they have access to primary health care through a family physician, family health team, walk-in clinic or other settings. 

• Patients who report having no access to primary health care have a higher percentage of ED visits for conditions that could potentially be managed in primary care — and the highest proportion of these visits take place on weekdays. 
• Patients who report having access to primary health care have a slightly higher percentage of these types of visits on weekends. 
• Similar trends exist for ED visits for conditions that could potentially be managed virtually.

Patients who report having access to primary care may not be able to get an appointment when they need it. 3 out of 4 Canadians report not being able to get a same- or next-day appointment.Reference5 A similar proportion do not find it easy to receive care after hours, on holidays or on weekends.Reference5 And 42% of Canadians report waiting more than 3 days to see their health care provider for a minor problem.Reference6

Our newest finding that 13% of ED visits by patients who report having access to primary care are visits for conditions that could potentially have been managed in that primary care setting. These findings suggest that even patients who are rostered to a family clinician or who have walk-in clinics nearby may have unmet needs for care in the community.
 

These indicator results supplement existing information on equity in accessing primary care.

We did not find that neighbourhood income was linked to marked differences in the percentage of visits to the emergency department for conditions that could be managed in primary care. But other robust research has shown that Canadians with lower incomes are less likely to have a regular health care provider than those with higher incomes.Reference5 Reference6

Other equity considerations have also been shown to be important factors for primary care access. But some of these were not included in our analyses because related information is not consistently available in the databases we used. Established research does show that people in certain racialized groups,Reference6 as well as First Nations, Inuit and Métis,Reference7 report lower access to primary care. 

• Taking the pulse: Measuring shared priorities for Canadian health care, 2024 
• The Expansion of Virtual Care in Canada: New Data and Information
• ºìÁì½í¹Ï±¨ equity and population health at CIHI
• from ºìÁì½í¹Ï±¨care Excellence Canada

If you have any questions or would like to learn more, please send us an email.

hsp@cihi.ca