Association between patient attachment to a regular doctor and self-perceived unmet health care needs in Canada: A population-based analysis of the 2013 to 2014 Canadian community health surveys

Int J Health Plann Manage. 2019 Jan;34(1):309-323. doi: 10.1002/hpm.2632. Epub 2018 Aug 29.

Abstract

Background: Although Canada operates a universal health care insurance system, equitable access to required health care services when needed still poses a challenge for some. The aim of this study was to examine the relationship between patient attachment to a family physician and self-perceived unmet health care needs (UHN) in Canada, after adjusting for predisposing, enabling, and need factors of the behavioral model of health services use.

Methods: This cross-sectional study used data from the Canadian Community Health Surveys, cycle 2013 to 2014. A sample of 58 462 individuals aged 12 years and over was analyzed. Logistic regression models were used to examine the relationship between patient attachment and self-perceived UHN.

Results: An estimated 10.41% of the Canadian population 12 years and older reported having UHN in the previous year. Among people with self-perceived UHN, there was significantly greater likelihood of unattachment to a family physician-no regular doctor or having a regular site of care, being younger, being female, being divorced, separated or widowed, having higher education, having lower income, having poorer perceived physical or mental health, having a weak sense of community belonging, having at least one chronic condition, and having greater activity limitations.

Conclusion: Ongoing public discourses on improving primary health care performance and reducing the burden of UHN in Canada should prioritize efforts that promote and facilitate the use of a regular family physician.

Keywords: family physician; health care management; health services use; patient attachment; unmet healthcare needs.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Canada
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Health Services Needs and Demand* / statistics & numerical data
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Object Attachment*
  • Physician-Patient Relations*
  • Physicians, Family*
  • Primary Health Care
  • Public Health
  • Young Adult