Challenges and impacts of specialist care wait times identified by family physicians: Results from a cross-sectional survey
Notice bibliographique
Résumé
<h3>Context:</h3> Canadians experience longer wait times for specialist referrals compared to other countries, which is a top barrier to health care in Canada and has a negative impact on patient health and quality of life. However, little is known about the impacts on primary care practice. <h3>Objective:</h3> To understand primary care provider (PCP) experiences of long wait times for specialist referrals, and the impacts on PCPs. <h3>Study design and analysis:</h3> A cross-sectional, linked survey was conducted. Descriptive statistics were computed for demographics, and response frequencies were calculated. Open text fields in the survey were thematically analyzed. <h3>Setting:</h3> Surveys were conducted as part of a larger study in Nova Scotia, Canada between 2015 and 2019. Follow-up surveys about specialist wait times were distributed between May and September of 2018. <h3>Population studied:</h3> PCP (i.e., family physician and nurse practitioner) respondents from the larger survey who agreed to participate in this follow-up survey. <h3>Instrument:</h3> Cross-sectional survey tool. <h3>Outcome measures:</h3> How specialist wait times affected primary care practice. <h3>Results:</h3> Of the 566 PCPs invited to take part in the initial survey, 98 (17.3%) agreed to participate in the follow-up survey, and 87 (88.78%) responded to the open-text question. Respondents’ ages ranged from 32 to 72 years, with representation across gender, provider type, practice type, and rurality. Of the 87 respondents, there were 156 responses to the open text question. We identified nine themes: 1) pervasiveness of problematic specialist wait times; 2) managing beyond scope while waiting for specialist care; 3) consequences for patients due to specialist wait times; 4) managing patient expectations while waiting for specialist care; 5) scheduling repeat visits to meet needs of patients; 6) “lost time” to manage patients waiting for specialist access; 7) additional work strategizing ways to access specialist care for patients; 8) provider experience of burnout, frustration and stress due to delayed specialist care; and 9) recommendations for accessing specialist care. <h3>Conclusion:</h3> Long wait times for specialist care in Nova Scotia have negative impacts on both patients and PCPs. Although PCPs took numerous steps to manage their patients in the interim, system-level changes are needed to reduce problematic wait times. These changes could support the health system across the Quintuple Aim.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».