Abstract
Measuring access to primary care is complicated due to a variety of perspectives. In Ontario, Canada, one of the main metrics currently used to evaluate access is the proportion of patients who are able to obtain a same- or next-day appointment with a primary care provider. However, this metric does not accurately reflect patients who do not medically require same- or next-day access. In this study, we demonstrate the need for developing more detailed metrics which capture the urgency of needed care via a case study of an Ontario primary care clinic. Our results show that using the standard metric, the clinic’s performance appears unsatisfactory, while using the more detailed acuity-based metrics, the clinic is shown to be performing well for non-urgent requests.
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References
Balasubramanian, H., Banerjee, R., Denton, B., Naessens, J., Stahl, J.: Improving clinical access and continuity through physician panel redesign. J. Gen. Intern. Med. 25(10), 1109–1115 (2010)
Ben-Gal, I.: Outlier detection. In: Data Mining and Knowledge Discovery Handbook, pp. 131–146. Springer (2005)
Bitton, A., Ratcliffe, H.L., Veillard, J.H., Kress, D.H., Barkley, S., Kimball, M., Secci, F., Wong, E., Basu, L., Taylor, C., et al.: Primary health care as a foundation for strengthening health systems in low-and middle-income countries. J. Gen. Intern. Med. 32(5), 566–571 (2017)
Canadian Association of Emergency Physicians. The Canadian Triage & Acuity Scale (CTAS). http://ctas-phctas.ca/?page_id=17. Accessed 2nd Mar. 2019
Canadian Institute for Health Information. Commonwealth fund survey 2016: Chartbook. Technical report (2017)
CIHI.: National health expenditure trends, 1975 to 2016. Canadian Institute for Health Information (2016)
Déry, J., Ruiz, A., Routhier, F., Gagnon, M.-P., Côté, A., Ait-Kadi, D., Bélanger, V., Deslauriers, S., Lamontagne, M.-E.: Patient prioritization tools and their effectiveness in non-emergency healthcare services: a systematic review protocol. Syst. Rev. 8(1), 78 (2019)
Globerman, S., Barua, B., Hasan, S.: The Supply of Physicians in Canada: Projections and Assessment (2018). http://www.fraserinstitute.org
Haggerty, J., Burge, F., Lévesque, J.-F., Gass, D., Pineault, R., Beaulieu, M.-D., Santor, D.: Operational definitions of attributes of primary health care: consensus among Canadian experts. Ann. Family Med. 5(4), 336–344 (2007)
Harding, K., Taylor, N.:. Triage in non-emergency services. In: Patient Flow: Reducing Delay in Healthcare Delivery, pp. 229–250. Springer (2013)
Health Quality Ontario. Measuring up 2018. Technical report (2018)
Hubert, M., Vandervieren, E.: An adjusted boxplot for skewed distributions. Comput. Stat. Data Anal. 52(12), 5186–5201 (2008)
Iserson, K.V., Moskop, J.C.: Triage in medicine, part i: concept, history, and types. Ann. Emerg. Med. 49(3), 275–281 (2007)
Jones, W., Elwyn, G., Edwards, P., Edwards, A., Emmerson, M., Hibbs, R.: Measuring access to primary care appointments: a review of methods. BMC Family Pract. 4(1), 8 (2003)
Laberge, M., Pang, J., Walker, K., Wong, S., Hogg, W., Wodchis, W.P., et al.: QUALICOPC (Quality and Costs of Primary Care) Canada: a focus on the aspects of primary care most highly rated by current patients of primary care practices (2014)
Llanwarne, N.R., Abel, G.A., Elliott, M.N., Paddison, C.A.M., Lyratzopoulos, G., Campbell, J.L., Roland, M.: Relationship between clinical quality and patient experience: analysis of data from the english quality and outcomes framework and the national GP patient survey. Ann. Family Med. 11(5), 467–472 (2013)
Ozen, A., Balasubramanian, H.: The impact of case mix on timely access to appointments in a primary care group practice. Health Care Manag. Sci. 16(2), 101–118 (2013)
Premji, K.: In Our Rush to Offer “McMedicine”, Do We Even Know What Patients Really Want? (2018). https://healthydebate.ca/opinions/same-day-access-family-doctor
Premji, K., Ryan, B.L., Hogg, W.E., Wodchis, W.P.: Patients’ perceptions of access to primary care: Analysis of the QUALICOPC patient experiences survey. Can. Family Phys. 64(3), 212–220 (2018)
Rao, M., Clarke, A., Sanderson, C., Hammersley, R.: Patients’ own assessments of quality of primary care compared with objective records based measures of technical quality of care: cross sectional study. BMJ 333(7557), 19 (2006)
Starfield, B., Weiner, J., Mumford, L., Steinwachs, D.: Ambulatory care groups: a categorization of diagnoses for research and management. Health Serv. Res. 26(1), 53 (1991)
Wang, W.-Y., Gupta, D.: Adaptive appointment systems with patient preferences. Manuf. Serv. Oper. Manag. 13(3), 373–389 (2011)
Wong, S.T., Chau, L.W., Hogg, W., Teare, G.F., Miedema, B., Breton, M., Aubrey-Bassler, K., Katz, A., Burge, F., Boivin, A., et al.: An international cross-sectional survey on the quality and costs of primary care (QUALICO-PC): recruitment and data collection of places delivering primary care across Canada. BMC Family Pract. 16(1), 20 (2015)
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Aslani, N., Fazileh, F., Mutasingwa, D., Terekhov, D. (2020). Acuity-Based Access Time Evaluation in Primary Care: A Case Study of an Ontario Clinic. In: Bélanger, V., Lahrichi, N., Lanzarone, E., Yalçındağ, S. (eds) Health Care Systems Engineering. ICHCSE 2019. Springer Proceedings in Mathematics & Statistics, vol 316. Springer, Cham. https://doi.org/10.1007/978-3-030-39694-7_22
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