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. 2006 Jan;1(2):103-19.

Experiencing difficulties accessing first-contact health services in Canada: Canadians without regular doctors and recent immigrants have difficulties accessing first-contact healthcare services. Reports of difficulties in accessing care vary by age, sex and region

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Experiencing difficulties accessing first-contact health services in Canada: Canadians without regular doctors and recent immigrants have difficulties accessing first-contact healthcare services. Reports of difficulties in accessing care vary by age, sex and region

Claudia Sanmartin et al. Healthc Policy. 2006 Jan.

Abstract

In this study, we identify the significant factors associated with having difficulties accessing first-contact healthcare services. Population-based data from two national health surveys, the Health Services Access Survey and the Canadian Community Health Survey, were used to identify respondents who required first-contact services for themselves or for a family member during 2003. Fifteen percent of Canadians reported difficulty accessing routine care, and 23% reported difficulties with immediate care. Physician/service availability was the chief reason cited for difficulties accessing routine care, while for urgent care, it was long wait times. Women, younger respondents and residents of eastern Canada and Quebec were consistently more likely to report difficulties accessing both types of these first-contact services, whereas less educated Canadians were less likely to report problems. Canadians without a regular family doctor were more than twice as likely to report difficulties accessing routine care compared to those who had a regular doctor. New immigrants were almost two and a half times more likely to report difficulties accessing immediate care than were Canadian-born respondents. Household income was not associated with difficulties accessing either type of care. The relatively low level of reporting of difficulties by older and less educated Canadians may be related, in part, to more modest expectations about the healthcare system.

Dans cette étude, nous répertorions les principaux facteurs liés aux obstacles à l’accès à des soins de santé de première ligne. Nous avons utilisé des données sur la population provenant de deux enquêtes nationales sur la santé – l’Enquête sur l’accès aux services de santé et l’Enquête sur la santé dans les collectivités canadiennes – pour repérer les répondants qui avaient besoin d’avoir accès à des services de santé de première ligne pour eux-mêmes ou pour un membre de leur famille en 2003. Quinze pour cent des Canadiens ont dit avoir éprouvé des difficultés à avoir accès à des soins de base, et 23 % ont dit avoir eu de la peine à trouver des soins immédiats. Les femmes, les répondants plus jeunes et les résidents de l’Est du Canada et du Québec étaient les plus susceptibles de signaler des difficultés d’accès aux deux types de soins de santé de première ligne, tandis que les Canadiens peu instruits étaient moins susceptibles d’en faire mention. Les Canadiens qui n’vaient pas de médecin de famille étaient plus que deux fois plus susceptibles de signaler des difficultés que ceux qui en avaient un. Les nouveaux immigrants étaient presque deux fois plus susceptibles de signaler des difficultés d’accès à des soins immédiats que les répondants nés au Canada. Il existe un profil sociodémographique indéniable associé au signalement des difficultés d’accès aux soins de première ligne au Canada. Le niveau relativement faible de signalement des difficultés d’accès par les Canadiens plus âgés et moins instruits peut être lié, en partie, à des attentes plus modestes à l’égard du système de soins de santé.

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