Better access to primary care key to improving health of Canadians
Primary health care is the foundation of Canada’s health care systems, delivering essential services that address the majority of health needs throughout an individual’s lifetime. Canadians count on their primary care providers to
- Treat illnesses and detect or prevent health problems
- Offer advice on healthy living
- Manage ongoing illnesses or recovery from injuries
- Provide end-of-life care
Research shows that people who do not have a primary care provider have worse health and higher rates of preventable diseases.Reference1
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I don’t have a family doctor, which makes it incredibly difficult to manage my arthritis, a chronic illness that started around 11 years old. For me, a minor health issue can turn into a mountain at the speed of light — and so it’s a fear every day that if I get sick, even with something minor, it’s another ER trip. Sometimes I let the issue turn into a mountain, because it’s just so exhausting to access the health care system. — Jenna Kedy, Patient Partner, Nova Scotia
Learn more about Jenna’s journey
Regular contact with a primary care provider can build a better understanding of a patient’s health history and care needs, which leads to more effective care. A strong primary health care system for all Canadians would allow them to access timely care in the community, thus reducing emergency department visits or hospitalizations for problems that can be managed in a doctor’s office or clinic.
All these benefits are why access to primary health care is one of the shared health priorities of the federal, provincial and territorial governments. The 2 indicators to measure access included in this report are
- Canadians With a Regular ºìÁì½í¹Ï±¨ Provider
- Ambulatory Care Sensitive Conditions Hospitalizations
Canadians With a Regular ºìÁì½í¹Ï±¨ Provider
Source
Statistics Canada. Canadian Community ºìÁì½í¹Ï±¨ Survey (CCHS) — Annual component, 2023 (provinces) and 2022 (territories).
Many Canadians struggle to find a regular health care provider. In 2023, 5.4 million (17%) Canadians age 18 and older said that they did not have access to a regular health care provider. Access varied depending on where people live and factors including sex, age and income.
In Canada, adults age 18 to 34 were the least likely to report that they had access to a regular health care provider (74%). Older adults age 65+ were the most likely to report access (92%).
The most affluent 20% of Canadians were slightly more likely to have a regular health care provider (84%) compared with the 20% with the lowest incomes (80%).
A recent survey of 10 high-income countries found that Canada lags in access to primary care, with the lowest percentage of adults age 18 and older having access to a regular care provider. Canadians also face greater difficulty getting same-day, next-day, evening or weekend appointments compared with people in the other countries surveyed.Reference2
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[Primary care] is really the front door to the health care system. It’s the first place people should go for care. Countries of the world that have primary care for everyone are the countries that get the best health outcomes, and the most affordable costs, because someone’s promoting and championing your health, and following you if you have a chronic illness over time. — Dr. Jane Philpott, Dean, Faculty of ºìÁì½í¹Ï±¨ Sciences, and Director, School of Medicine, Queen’s University; Family Physician; and Former Federal Minister of ºìÁì½í¹Ï±¨, in Fixing Family Medicine, Canadian ºìÁì½í¹Ï±¨ Information Podcast, May 27, 2024
Ambulatory Care Sensitive Conditions Hospitalizations
Ongoing care from a regular health provider can help prevent, detect and manage chronic diseases. When regular care isn’t available, a patient may miss out on medications or treatments that could help control their symptoms and potentially slow the progression of their condition. Chronic diseases — including angina, asthma, chronic obstructive pulmonary disease (COPD), diabetes, congestive heart failure (CHF) , epilepsy and high blood pressure — are known as ambulatory care sensitive conditions (ACSCs), because if they are managed well through primary care, patients are less likely to need hospital care.
Ambulatory care refers to treatment that is offered in the community without needing a hospital stay. Not every hospital admission for ACSCs can be avoided, but patients without a regular primary health care provider may experience severe illness more often, increasing their need for emergency department visits, hospitalizations and even long-term care.Reference3
For this measure, a lower rate is better, because it means that fewer people went to the hospital for a problem that potentially could have been avoided with primary care treatment. In 2023–2024, Canada’s age-standardized rate (meaning numbers have been adjusted to account for differences in population age groups) for these potentially avoidable hospitalizations was 281 per 100,000 people younger than 75.
Overall, variation remains across the country by geography, age, sex and income. ACSC hospitalizations were higher among adults age 60 to 74, those with COPD and males (compared with females). Canadians who lived in the highest-income neighbourhoods were less likely to be hospitalized for ACSCs (169 per 100,000) than people from the lowest-income neighbourhoods (466 per 100,000).
What do we need to know more about?
There are several programs across the country that focus on improving the lives of people with chronic diseases by preventing or slowing the progression of their conditions. It is important to learn about which of these programs work best for which patients.
Canada’s health workforce is under great strain. Doctors are working longer hours but seeing fewer patients.Reference4 More research is required to determine how care is changing, looking for ways to lighten the load on physicians, nurses, nurse practitioners and other providers, including family caregivers.
Additional indicators to measure Canadians’ ability to get care on the same or next day when sick, whether they are treated with dignity and respect by their health care providers, and access to interdisciplinary primary care health teams will provide a fuller picture of the state of primary care. That will help health care planners and providers deliver effective primary care more efficiently, making it easier for patients and families to find care when they need it.
Related resources
References
1.
Starfield B, Shi L, Macinko J. . The Milbank Quarterly. 2005.
2.
Canadian Institute for ºìÁì½í¹Ï±¨ Information. International survey shows Canada lags behind peer countries in access to primary health care. Accessed July 23, 2024.
3.
Shi L. . Scientifica. 2012.
4.
Canadian Institute for ºìÁì½í¹Ï±¨ Information. Survey results reveal the challenges experienced by family doctors. Accessed July 23, 2024.
How to cite:
Canadian Institute for ºìÁì½í¹Ï±¨ Information. Better access to primary care key to improving health of Canadians. Accessed April 3, 2025.
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