Addressing the Crisis in Access to Primary to Primary Care: A Targeted Approach
Posted on September 29, 2024 in Health Delivery System
Source: CDHowe.org — Authors: John Richards
CDHowe.org – Public Policy Research
September 19, 2024. John Richards
- In the latest OECD national satisfaction survey on “availability of quality health care,” Canadians gave our healthcare system a mark well below the OECD average. In a large 2022 Angus Reid survey of access to health care, 60 percent responded that they face “chronic difficulty” or “some challenges.”
- No single explanation of dysfunction – the COVID pandemic, aging of the population, inadequate public financing, or decline in physician hours – is satisfactory. Collectively, they are a partial explanation.
- However, a major cause for the dysfunction is the reluctance of provincial governments to undertake institutional reforms, for fear of provoking interest groups – particularly physicians’ organizations. The provinces have not made major changes to their health delivery systems since forced to do so by the deficit crises of the 1990s.
- Studies have repeatedly shown that nurse practitioners can deliver equally good care as family physicians in most situations, while costing the healthcare system less. Capitation, where healthcare providers are paid based on how many patients they have on their roster, gives clinics the flexibility to adjust their services in response to patient needs, allowing better care at somewhat lower cost.
- The author recommends two targeted reforms:
—an aggressive increase in the number of nurse practitioners working in community primary care, usually in multi-discipline clinics; and
—expansion, beyond Ontario, in rostering patients and expanding capitation in multi-discipline clinics.
Download PDF: https://www.cdhowe.org/sites/default/files/2024-09/E-Brief_360.pdf
Contents
- The Study in Brief
- Introduction
- Influence of Physicians’ Associations
- Generational Changes among Canadian Physicians
- Reform Options
- Conclusion
- References
John Richards has written extensively on social policy in Canada and his current social policy focus is on Aboriginal policy. He is a Professor, Public Policy Program, at Simon Fraser University. He co-edits (with Henry Milner) Inroads, a Canadian policy journal. In addition, he has undertaken teaching and research in Bangladesh over the last decade.
https://www.cdhowe.org/public-policy-research/addressing-crisis-access-primary-care-targeted-approach
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