Queen’s University team leads primary care study in Ontario

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A group of researchers affiliated with Queen’s University use the data they collect to inform state health policy.

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Inspire-PHC is a government-funded group of researchers at Ontario universities, led by a team at Queen’s University, that has been collecting, organizing and sharing data on Ontario’s healthcare system for 15 years.

On Wednesday, researchers 2022 Primary Health Care Data Reportinformation gathered from the province’s 54 Ontario Health Teams (reorganized neighborhoods replacing the province’s old Local Health Integration Network (LHIN) system) was shared with hundreds of primary care providers throughout the province during daytime webinars. was provided to

This is the first presentation of Ontario Health Teams data since 2020.

According to Eliot Frymire, research manager at Queen’s University’s Center for Health Services and Policy Studies and project manager for Inspire-PHC, the data show that the health care system is becoming less accessible.

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“We’re trying to find out who’s attached and who doesn’t have a primary care doctor,” Freimia told Whig-Standard. There are more and more people.”

In March 2022, more than 2.2 million Ontario residents (14.7%) lacked primary health care, up from 1,778,022 or 12.2% in 2020.

In the Frontenac, Lenox, and Addington Health Teams regions, that number increased from 8.5% to 9.3% from 2020 to 2022, but the methodology behind Ontario’s Health Teams attribution network was completely irrelevant. It’s not the latest, so it could be even higher today.

“Newborn babies and people who moved to states without OHIP cards were never arrested,” Frymire explained. “There are some data missing in this, but the bottom line is that unmarried rates of primary care inaccessibility continue to rise, and are rising across all categories.”

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Various Ontario health agencies and government agencies report varying numbers of unenrolled patient numbers, many of which are much higher than Inspire-PHC put forward, called “virtual enrolments.” We still access things on a regular basis for care, namely family physicians who come down to categories of patients that are not technically associated.

“We look at it as a regular, regular provider that they go to,” explained Frymire.

“Virtually enrolled” patients (not to be confused with individuals who see a doctor via online access) account for approximately 10% of patients in the Frontenac, Lenox and Addington areas, or more than 12,000 .

Other methodologies for measuring unconnected patients do not effectively distinguish between roster and unconnected patients and do not group their numbers. However, both the Department of Health and the Ontario Ministry of Health use data from Inspire-PHC when analyzing people who are not attached to their primary care physician.

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“We’ve been working on this for 10 or 12 years,” says Frymire. “There are papers validating this approach and it is accepted as a sound approach in the scientific literature.”

The Inspire-PHC report provides an in-depth analysis of all patient demographics, patient characteristics, primary care metrics, and healthcare utilization recorded within the state.

This includes who participates or does not participate in primary care, age, gender, income, ethnic diversity, marginalization, comorbidities, chronic illness, frailty, mental health diagnosis, emergency room This includes more detailed investigations such as medical examinations.

All of these figures are available statewide or broken down by Ontario Health Team region.

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The report also breaks down geographically those who have access to team-based primary care, those who do not have access, and those who do not have access to primary care.

Team-based primary care at family health clinics and community health centers varies statewide. This is well implemented in the Kingston area, where more than 50% of her primary care patients receive that care in a team setting.

“Kingston is very fortunate to have many patients in team-based care, where a range of care providers – including (occupational therapists), (physiotherapists), pharmacists, and social workers – encompasses physicians. said Flymere.

A worrying rising trend across the state is the number of children without primary care providers.

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“Across Ontario, we have seen a significant increase in the number of untreated pediatric patients,” said Frymire.

From 2020 to 2022, the number of Ontario children not receiving regular primary care increased from 215,901 (7.4%) to 359,769 (12.9%).

“I think we all agree that children should have access to primary care providers,” said Freimia. “We just don’t see this, and the number of inaccessible children is increasing.”

According to Frymire, data continue to point to inconsistencies in access to primary care across income groups, showing that those who have the most difficulty accessing primary care are those who “can’t afford not to have access.” increase.

“There’s a bit of ‘reverse care’ going on here. That means healthy and wealthy people in Ontario may have better access to care than those who really need it,” explained Freimia.

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The Inverse Law of Care, an idea published over 50 years ago by Julian Tudor Herd, illustrates the inverse relationship between healthcare and those who access it most and those who need it most.

“This is not a phenomenon unique to healthcare,” says Frymire. “We see it in a lot of different things, but we definitely see it in health care where people will be able to contribute more resources to the provision of health care.”

People with higher incomes have better conditions for accessing primary care, such as owning a car, being able to take time off work on weekdays for appointments, and using sick time for elective surgeries. I have.

“When you look at income quintiles, you’ll always find a direct relationship between income quintiles and rates of attachment to primary care providers,” he said. The quintile of the population always has the worst access to primary care, and the highest quintile, the top 20% of income groups, have the best access to care.

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This is not unique to Kingston. Ontario and all of Canada. ”

The data collected and organized by Inspire-PHC is used by the Ontario Department of Health, the Ministry of Health and other organizations to direct policy development and change. The trend is going in the opposite direction, so changes need to be made to better provide the care people need, Freimia said.

“Generally, we are in a crisis statewide,” he said. “This state is better than most other states in that most people have primary care providers. But there are still many people without primary care providers.”

to see 2022 Primary Health Care Data Report and other detailed data can be found here www.inspire-phc.org.

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