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Record W4398173643 · doi:10.1503/cmaj.231372

Public experiences and perspectives of primary care in Canada: results from a cross-sectional survey

2024· article· en· W4398173643 on OpenAlexfundvenueaboutno aff
Tara Kiran, Maryam Daneshvarfard, Ri Wang, Alexander Beyer, Jasmin Kay, Mylaine Breton, Danielle Brown-Shreves, Amanda Condon, Michael Green, Lindsay Hedden, Alan Katz, Maggie Keresteci, Neb Kovacina, M Ruth Lavergne, Aïsha Lofters, Danielle Martin, Goldis Mitra, Sarah Newbery, Katherine Stringer, Peter MacLeod, Clifton van der Linden

Bibliographic record

VenueCanadian Medical Association Journal · 2024
Typearticle
Languageen
FieldHealth Professions
TopicPrimary Care and Health Outcomes
Canadian institutionsnot available
FundersCanadian Medical AssociationMax Bell Foundation
KeywordsCross-sectional studyPrimary careEnvironmental healthMedicineFamily medicine

Abstract

fetched live from OpenAlex

<h3>Background:</h3> Through medicare, residents in Canada are entitled to medically necessary physician services without paying out of pocket, but still many people struggle to access primary care. We conducted a survey to explore people’s experience with and priorities for primary care. <h3>Methods:</h3> We conducted an online, bilingual survey of adults in Canada in fall 2022. We distributed an anonymous link through diverse channels and a closed link to 122 053 people via a national public opinion firm. We weighted completed responses to mirror Canada’s population and adjusted for sociodemographic characteristics using regression models. <h3>Results:</h3> We analyzed 9279 completed surveys (5.9% response rate via closed link). More than one-fifth of respondents (21.8%) reported having no primary care clinician, and among those who did, 34.5% reported getting a same or next-day appointment for urgent issues. Of respondents, 89.4% expressed comfort seeing another team member if their doctor recommended it, but only 35.9%, 9.5%, and 12.4% reported that their practice had a nurse, social worker, or pharmacist, respectively. The primary care attribute that mattered most was having a clinician who “knows me as a person and considers all the factors that affect my health.” After we adjusted for respondent characteristics, people in Quebec, the Atlantic region, and British Columbia had lower odds of reporting a primary care clinician than people in Ontario (adjusted odds ratio 0.30, 0.33, and 0.39, respectively; <i>p</i> &lt; 0.001). We also observed large provincial variations in timely access, interprofessional care, and walk-in clinic use. <h3>Interpretation:</h3> More than 1 in 5 respondents did not have access to primary care, with large variation by province. Reforms should strive to expand access to relationship-based, longitudinal care in a team setting.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.004
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.134
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.004
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.069
GPT teacher head0.368
Teacher spread0.299 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations35
Published2024
Admission routes3
Has abstractyes

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