A new medical study said health care reforms in Canada should encourage more people to access their primary health care provider closer to home.
The study published in the Canadian Medical Association Journal (CMAJ.ca) said with more than 10 per cent of patients living more than 30 kilometres from their family physician, those patients were less likely to use primary care, less likely to take advantage of screening programs, and more likely to use emergency care in the event of illness or injury.
The study said there are many cases where people will move from one residence to another but will keep the same primary care provider. The study collected data from nearly 10 million patients across Ontario, in both urban and suburban settings, who were enroled with a primary care giver, a physician or nurse practitioner as of March 31, 2023.
"In Canada, patients who move may choose to stay on their original family physician’s roster, creating long distances to seek primary care. We sought to explore how distance to primary care affected health care use and quality of care," said the study.
"We included 9,967,955 patients. Of these, 1,261,112 (12.7 per cent) patients lived farther than 30 kilometres from their family physician. These patients had greater odds of having non-urgent emergency department visits in the past year, having no visits with any family physician in the previous two years; and not having had screening for colon cancer, breast cancer and cervical cancer," said the study.
The study's authors also wrote that the reverse situation was true for those patients living closer to their health care provider.
"Proximity to primary care was associated with higher use of primary care, reduced emergency department use, and increased uptake of recommended cancer screening, underscoring the importance of reforms that enhance access to care close to home," said the study.
The authors also wrote that over the past decade, access to primary care has declined across Canada, and countries worldwide face similar challenges.
"This decline was accelerated by the COVID-19 pandemic, which strained the existing inadequate human resource capacity," said the study.
The authors quoted a House of Commons report, dated March 2023, that described Canada's health workforce as being in crisis.
"Anecdotally, and perhaps as a result of the worsening workforce shortages in primary care, patients continue to stay connected to their family physicians, even after moving, which is a particular concern in the context of the vast geographic distances in Canada," said the study.
The authors concluded that having access to primary care close to home was associated with higher continuity of care, lower emergency department use, and more recommended cancer screening. Primary care reforms should prioritize providing people access to care close to home, said the study.
The full online text version of the study is available here.