January 28, 2016 — An international survey of primary care physicians suggests that access to regular and after-hours primary care is improving for Canadian patients, and that uptake of electronic medical records is increasing among Canadian doctors. However, Canada remains below average on 19 out of 28 featured indicators of care from The Commonwealth Fund survey.
These and more insights come from How Canada Compares: Results From The Commonwealth Fund 2015 International Health Policy Survey of Primary Care Physicians, released today by the Canadian Institute for Health Information (CIHI) in partnership with the Canadian Institutes of Health Research, and with co-funding from Canada Health Infoway.
The Commonwealth Fund survey polled primary care doctors in 10 countries on topics such as access to care, coordination of patient care, organization of practice, use of information technology and performance measurement.
Access to care is improving but still a challenge for many Canadians
- 70% of Canada’s primary care doctors thought their patients often experienced long wait times to see a specialist. This is the highest proportion among all the countries.
- The proportion of doctors who thought their patients often experienced long wait times to get treatment after diagnosis decreased from 29% to 21% between 2009 and 2015.
- The proportion of doctors who said that most of their patients can get same- or next-day appointments increased from 39% to 53% between 2009 and 2015.
- 40% of Canadian primary care doctors thought their patients often experienced difficulty, like a long wait time, to get specialized diagnostic tests (e.g., CT imaging, mammogram, MRI).
Coordination of patient care shows room for improvement, despite being above the international average in some areas
- Although the percentage for Canada is slightly better than the average of 10 countries, 71% of Canadian doctors do not always receive relevant information about their patients after they have been seen by a specialist. This includes changes to the patients’ medications and care plans.
- 22% of Canadian primary care doctors said that after a patient has been discharged from hospital, it takes more than 15 days on average to get the information they need to continue managing the patient’s care. This is the longest delay among the countries surveyed.
- Half of the Canadian doctors said that at least 1 of their patients had experienced problems in the past month because care was not well coordinated across multiple sites or providers.
New models of primary care delivery appear to be making a difference
- Slightly more than half of Canadian primary care doctors work as part of a primary care team–based model supported by public funds, such as family care clinics in Alberta.
- 55% of physicians who work in primary care models frequently coordinate with social services or other community care providers, compared with 44% of physicians in other models.
- Half of the physicians who work in primary care models follow up with hospitals when their patient is discharged, while 44% of physicians in other models do the same.
- Almost 60% of physicians in primary care models offer after-hours care, compared with 37% of physicians in other practice models. However, there was no difference between models in the proportion of doctors able to provide same- or next-day appointments to most of their patients.
- 81% of physicians in primary care models use electronic medical records, compared with 64% in other practices.
There was a big improvement in the use of electronic medical records (EMRs) in Canada
- The proportion of doctors using EMRs increased from 37% to 73% between 2009 and 2015, due in large part to significant funding from provinces and territories, as well as Canada Health Infoway.
“Canadian doctors are telling us that new models of primary care delivery can help make a difference in their patients’ care. This survey reveals that doctors working in family health teams, or other publicly funded models of primary care, are having better results than their peers in terms of access, continuity and quality of care for their patients. In the future, we will need to better understand the cost-effectiveness of these models and whether they offer the best value for money both for patients and for the health system.”
— Kathleen Morris, CIHI's vice president of Research and Analysis.
The matrix below provides a summary of Canadian results by theme compared with the international average of countries. The number in each cell represents the number of indicators in each theme that are below, the same as or above The Commonwealth Fund (CMWF) average of 10 countries.
|Theme||Below average||Same as average||Above average|
|Access to care||5||1||0|
|Coordination of care||6||1||6|
|Information technology adoption||4||0||0|
About The Commonwealth Fund
Based in the United States, The Commonwealth Fund is a private foundation that aims to promote a high-performing health care system that achieves better access, improved quality and greater efficiency, particularly for society’s most vulnerable populations.
The Commonwealth Fund 2015 International Health Policy Survey of Primary Care Physicians received core funding from The Commonwealth Fund and co-funding from the following organizations for an expanded Canadian sample within Canada: the Canadian Institute for Health Information; the Canadian Institutes of Health Research; Canada Health Infoway; the Commissaire à la santé et au bien-être du Québec; and Health Quality Ontario.
Funding from the following organizations was provided for the survey outside of Canada:
- Bureau of Health Information (Australia);
- La Haute Autorité de santé (France);
- the Caisse nationale de l’assurance maladie des travailleurs salariés (France);
- BQS Institute for Quality and Patient Safety (Germany);
- the German Federal Ministry of Health;
- the Dutch Ministry of Health, Welfare and Sport;
- the Scientific Institute for Quality of Healthcare, Radboud University Nijmegen (the Netherlands);
- the Norwegian Knowledge Centre for the Health Services;
- the Swedish Ministry of Health and Social Affairs;
- the Swiss Federal Office of Public Health;
- the Health Foundation (UK);
- and many other country partners.
- Commonwealth Survey 2015
- OECD eTool: CIHI uses international comparisons like this survey to create a snapshot of how Canada compares on important health issues. For broader information on international comparisons, check out CIHI’s OECD eTool. It includes more than 50 indicators on many different parts of health care and allows for direct comparisons between provinces and more than 30 countries.
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