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Research ArticleResearch

Patients’ perceptions of access to primary care

Analysis of the QUALICOPC Patient Experiences Survey

Kamila Premji, Bridget L. Ryan, William E. Hogg and Walter P. Wodchis
Canadian Family Physician March 2018; 64 (3) 212-220;
Kamila Premji
Family physician in Ottawa, Ont, a recent graduate of the Clinician Scholars program at the University of Ottawa, and a doctoral candidate at Western University’s Centre for Studies in Family Medicine in London, Ont.
MD CCFP
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  • For correspondence: kpremji@uwo.ca
Bridget L. Ryan
Assistant Professor in the Department of Family Medicine and the Department of Epidemiology and Biostatistics at Western University.
PhD
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William E. Hogg
Clinician Investigator at the Bruyère Research Institute and Senior Research Advisor in the Department of Family Medicine at the University of Ottawa.
MD CCFP FCFP
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Walter P. Wodchis
Associate Professor at the Institute of Health Policy, Management and Evaluation at the University of Toronto in Ontario, Research Scientist at the Toronto Rehabilitation Institute, and Adjunct Scientist at the Institute for Clinical Evaluative Sciences.
PhD
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    Figure 1.

    Responses to access-related items on the QUALICOPC Patient Experiences Survey: The denominators vary because not all questions were answered by all respondents.

    QUALICOPC—Quality and Costs of Primary Care.

Tables

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    Table 1.

    Items contributing to the Composite Access Score

    QUALICOPC PES STATEMENT OR QUESTIONQUALICOPC PES RESPONSE OPTIONSRECODING FOR ANALYSIS*
    The opening hours are too restrictedYes, no, don’t know
    • Yes = 1

    • No = 2

    • Don’t know = missing

    When I called this practice, I had to wait too long to speak to someoneYes, no, don’t know
    • Yes = 1

    • No = 2

    • Don’t know = missing

    I know how to get evening, night, and weekend servicesYes, no, don’t know
    • Yes = 2

    • No = 1

    • Don’t know = 1

    If I need a home visit I can get oneYes, no, don’t know
    • Yes = 2

    • No = 1

    • Don’t know = missing

    For patients who had made an appointment for today’s visit: Was it easy to get the appointment?Yes, no
    • Yes = 2

    • No = 1

    How many days did you wait for this visit from the time that you tried to make an appointment?Made the appointment earlier today, made the appointment yesterday, waited 2–7 d, waited more than 1 wk, don’t know
    • Earlier today or yesterday = 2

    • 2–7 d or more than 1 wk = 1

    • Don’t know = missing

    Were you able to arrange an appointment with the doctor as soon as you wanted to?Yes, no
    • Yes = 2

    • No = 1

    The practice is too far away from where I am living or workingYes, no, don’t know
    • Yes = 1

    • No = 2

    • Don’t know = missing

    I can usually see my regular doctor every time I visitYes, no, don’t know
    • Yes = 2

    • No = 1

    • Don’t know = missing

    I can see other doctors in this practice if my doctor is not availableYes, no, don’t know
    • Yes = 2

    • No = 1

    • Don’t know = 1

    I can see other health care professionals in this practice (eg, nurse practitioner, nurse, dietitian, or pharmacist) without having to see a doctorYes, no, don’t know
    • Yes = 2

    • No = 1

    • Don’t know = 1

    • QUALICOPC PES—Quality and Costs of Primary Care Patient Experiences Survey.

    • ↵* A code of 1 is unfavourable and 2 is favourable.

    • View popup
    Table 2.

    Characteristics of respondents: The denominators vary because not all questions were answered by all respondents.

    CHARACTERISTICRESPONDENTS, %
    Birth country (n = 1650)
      • Born in Canada75.0
      • Born outside of Canada25.0
    English- or French-language fluency (n = 1642)
      • Fluent or native speaker75.1
      • Sufficient15.7
      • Moderate4.1
      • Poor2.4
      • Not at all2.7
    Self-reported general health (n = 1678)
      • Very good23.8
      • Good50.2
      • Fair21.3
      • Poor4.7
    Household income compared with the rest of Canada (n = 1629)
      • Average57.0
      • Above average23.2
      • Below average19.8
    Highest level of education (n = 1641)
      • Postsecondary education63.7
      • Upper-secondary education (grades 10–12)29.9
      • No qualifications, preprimary, primary, or lower-secondary education6.4
    Presence of a chronic disease (n = 1685)
      • Yes53.6
      • No46.4
    No. of visits to a doctor in the past 6 mo, including current visit (n = 1649)
      • 113.3
      • 225.5
      • 3–541.9
      • ≥ 619.2
    No. of visits to an ED within the past 12 mo (n = 1676)
      • None63.8
      • 120.9
      • 2–312.5
      • ≥ 42.8
    • ED—emergency department.

    • View popup
    Table 3.

    Effect of patient characteristics on the Composite Access Score: Results of a multi-level mixed-effects linear regression (n = 1469).

    VARIABLEβZP VALUE95% CI
    Older age.0012.88.0040.000 to 0.001
    Birth country outside of Canada−.008−2.42.015−0.014 to −0.001
    Poorer self-reported general health−.020−3.29.001−0.032 to −0.008
    Frequent visits to a doctor.0122.63.0090.003 to 0.021
    Absence of a chronic disease−.008−0.08.422−0.026 to 0.011
    Frequent ED visits−.006−1.19.234−0.017 to 0.004
    Female sex−.014−1.59.112−0.031 to 0.003
    Poorer fluency in English or French.0010.28.777−0.008 to 0.011
    Lower income−.008−1.15.251−0.021 to 0.006
    Lower education−.005−0.67.503−0.020 to 0.010
    • ED—emergency department.

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Canadian Family Physician: 64 (3)
Canadian Family Physician
Vol. 64, Issue 3
1 Mar 2018
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Patients’ perceptions of access to primary care
Kamila Premji, Bridget L. Ryan, William E. Hogg, Walter P. Wodchis
Canadian Family Physician Mar 2018, 64 (3) 212-220;

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Canadian Family Physician Mar 2018, 64 (3) 212-220;
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