DiagnosticsMost, But Not All, Canadians With Chronic Conditions Get Clinically Recommended Tests
Most Canadians with chronic conditions have a regular place of care, but there are some reported gaps in the management of their conditions according to a new study released today by the Canadian Institute for Health Information (CIHI). The study, Experiences With Primary Health Care in Canada, measures access to and quality of care from a patient perspective across Canada"s 10 provinces. The study is based on the responses of more than 11,000 people age 18 and older to Statistics Canada"s 2008 Canadian Survey of Experiences With Primary Health Care, which was jointly funded by CIHI and the Health Council of Canada.
"Primary health care typically represents a patient"s first point of contact with the health system and includes a range of activities, from ongoing care for chronic conditions to care for urgent but minor or common health problems," says Greg Webster, Director of Primary Health Care Information at CIHI. "Gaps in primary health care access, continuity and quality can lead to poorer health for patients and increased demand for hospital-based services. This CIHI report provides new insight into the experience of Canadians with primary health care."
The survey found that 41% of Canadian adults reported they had at least one of seven common chronic conditions (arthritis, cancer, emphysema or chronic obstructive pulmonary disease, diabetes, heart disease, high blood pressure and mood disorders, not including depression), with the vast majority (96%) of them reporting they had access to a regular place of care, such as a family doctor or a walk-in clinic.
Most, but not all, of the respondents with at least one of four major chronic conditions reported getting clinically recommended tests from their primary health care provider to monitor their conditions. The majority (94%) of patients with diabetes, heart disease, stroke and/or high blood pressure had a blood pressure measurement in the past 12 months, while 82% had their cholesterol levels tested, 80% had their blood sugar tested and 74% had their weight checked by their primary health care provider.
However, the survey found 40% of those with at least one of the seven common chronic conditions reported not having made a treatment plan with their provider within the last 12 months, and less than one in four were provided with a written list of instructions to manage their disease (23%). In addition, 40% of patients with three or more chronic conditions reported they were rarely or never counselled in the last 12 months about what to do to improve their health.
"Health promotion, disease prevention and self-management activities are particularly important to maintain health for all people and prevent complications for people who have chronic health conditions," says Dr. Sharon Johnston, family physician and University of Ottawa professor. "This finding definitely points to the need for improvements in helping patients to take care of their health between primary health care visits."
Majority of Canadians have access to primary health care, but one in eight reports difficulties in accessing care
The majority (91%) of all Canadians surveyed (including those without chronic conditions) reported having a regular place to go when they are sick or need advice about their health; the study found that most of these people chose a doctor"s office (78%), while 17% selected a walk-in clinic, centre local de services communautaires (CLSC) or community health centre as their usual place of care.
More than half (54%) of those surveyed required routine or ongoing medical care within the past 12 months. Of these, 13% experienced difficulties getting the care they needed, with the most frequent reasons for this including waiting too long to get an appointment, difficulty getting an appointment and difficulty contacting a physician. About two-thirds (68%) of patients requiring routine or ongoing care received care in seven days or less. For adults requiring urgent care for a minor problem, 85% received care within one day, 11% received care in two to seven days and 4% received care in more than seven days.
Most Canadians rate quality of primary health care highly
Primary health care teams are those made up of professionals from different disciplines working together to provide patient care. Some research shows that the benefits of this approach can include better access to services, shorter wait times and more comprehensive care. According to the survey results, 27% of Canadians reported that a nurse was involved in their care, while 16% reported that their usual place of care involved other health professionals, such as dietitians and nutritionists.
Nearly two-thirds (65%) of Canadians reported that in the past 12 months their regular doctor always allowed them enough time to discuss their feelings, fears and concerns about their health. More than three-quarters (76%) reported that the quality of the primary health care they received in the past 12 months was either "excellent" or "very good." In addition, 92% of Canadians with a regular place of care would recommend their doctor to a friend or relative.
The Canadian Institute for Health Information