Do New and Traditional Models of Primary Care Differ with Regard to Access?: Canadian QUALICOPC Study

Objective: To examine access to primary care in new and traditional models using 2 dimensions of the concept of patient-centred access.

Design: An international survey examining the quality and costs of primary health care (the QUALICOPC study) was conducted in 2013 in Canada. This study adopted a descriptive cross-sectional survey method using data from practices across Canada. Each participating practice filled out the Family Physician Survey and the Practice Survey, and patients in each participating practice were asked to complete the Patient Experiences Survey.

Setting: All 10 Canadian provinces.

Participants: A total of 759 practices and 7172 patients.

Main Outcome Measures: Independent t tests were conducted to examine differences between new and traditional models of care in terms of availability and accommodation, and affordability of care.

Results: Of the 759 practices, 407 were identified as having new models of care and 352 were identified as traditional. New models of care were distinct with respect to payment structure, opening hours, and having an interdisciplinary work force. Most participating practices were from large cities or suburban areas. There were few differences between new and traditional models of care regarding accessibility and accommodation in primary care. Patients under new models of care reported easier access to other physicians in the same practice, while patients from traditional models reported seeing their regular family physicians more frequently. There was no difference between the new and traditional models of care with regard to affordability of primary care. Patients attending clinics with new models of care reported that their physicians were more involved with them as a whole person than patients attending clinics based on traditional models did.

Conclusion: Primary care access issues do not differ strongly between traditional and new models of care; however, patients in the new models of care believed that their physicians were more involved with them as people.