Inter-provincial variation and determinants of access to team-based primary care in Canada

Abstract

Background: Team-based care involves family physicians working with other health professionals to provide primary care to patients. It has been implemented across Canada; however, its adoption varies, as health care delivery is the responsibility of provincial governments and not the federal government.
Objective: To examine variations in the composition of team-based primary care amongst Canadian provinces in 2008 and identify patient characteristics that may have predicted access.
Methods: Data are from the 2008 Canadian Survey of Experiences with Primary Health Care, a national survey of patients‘ experiences with primary care in Canada. The sample size available for analysis was 11,521 and the response rate was 70.8%. Team-based care was defined as a family physician working with either a nurse or another type of
health provider. Logistic regression was used to examine determinants of access to team-based care, adjusting for demographic, health status, and socioeconomic variables.
Results: In 2008, 37.1% of Canadians reported having access to team-based care. The composition of team-based care varied amongst provinces and the most common model in all provinces were family physician plus nurse-only teams except in Quebec and Manitoba. Statistically significant predictors of access to team-based care were
province of residence and total number of chronic conditions.
Conclusion: With continuity of primary care reform in Canada, a new national survey is needed. Future assessments should aim to increase accuracy in the definition of team-based care through improvements in survey question design and patient education.