Supporters gather for the We Need Doctors Now rally at the legislature in Victoria, on Oct. 22, 2022.CHAD HIPOLITO/GM
More than five million Canadian adults struggle to access primary care, according to a new report on the status of priority areas in health care identified by three levels of government.
The report, titled Taking the Pulse: Measuring Shared Priorities for Canadian Health Care, was released Thursday by The Canadian Institute for Health Information. Federal, provincial and territorial governments agreed last year to work with CIHI in order to keep Canadians informed on key health topics, such as expanding family health services and primary care access.
Other priorities identified by the levels of government include the need to bolster the health work force, reduce surgery wait times, and improve mental-health access and substance-use services. Additionally, there is also a focus on modernizing health information systems and tools used to share electronic health information.
Canada has a limited pool of available primary care providers, which strains emergency care, health experts say. Primary care involves the delivery of services including to treat illnesses, detect health problems, manage continuing health challenges and recoveries. Research shows individuals who do not have access to a primary care provider, such as a doctor or nurse practitioner, have worse health and higher rates of preventable diseases, CIHI says.
The lack of access to primary care providers was exacerbated by the COVID-19 pandemic, turning the recruitment and retention of such professionals into key political issues across the country.
In its new report, CIHI found that 83 per cent of Canadians, or 26.2 million people, reported having access to a regular health care provider in 2023, while the other 17 per cent, or 5.4 million, struggle to access the primary care that they need. Access varied depending on location and other factors including sex, age and income.
CIHI found that 281 of every 100,000 Canadians younger than 75 were admitted to a hospital for a problem that could have been avoided with access to appropriate care in the community in 2023-2024. Similarly, there were differences across Canada depending on geography and other factors.
The CIHI findings reinforce a report published earlier this year by three senators, which says Canada faces a primary care crisis in which 10 million Canadians could be without a family doctor in the next decade.
In Ontario, Premier Doug Ford’s government has faced criticism, both from advocates and opposition parties, about the level of access to family doctors in the province. This week, the province announced that it tapped former federal health minister Jane Philpott to lead a new action team on the issue.
Dr. Philpott, the dean of the health sciences faculty at Queen’s University said the goal is for 100 per cent of Ontarians to be attached to a family doctor or nurse practitioner.
Canada also lags in access to primary care compared with other high-income countries, with the lowest percentage of adults age 18 and older having access to a regular care provider, according to an international study of adults in 10 high-income countries. It identified that Canadians also face greater difficulty accessing appointments on the same day, the next day, in the evening and on weekends.
CIHI’s latest findings show that almost all provinces and territories had a net increase in the number of family physicians in 2021–2022, and nurses and nurse practitioners in 2022, compared with the year prior. The organization says this means more of these professionals entered the work force than left it.
CIHI also found that the number of surgeries completed in Canada has rebounded to prepandemic levels, with more than 2.3 million surgeries performed in 2023-2024 – an increase of 5 per cent over 2019-2020.
Between April and September, 2023, 81 per cent of urgent hip fracture surgeries were completed within a 48-hour benchmark, though only 62 per cent of planned hip or knee replacements met a 26-week benchmark.
On mental health and substance use, CIHI found half of Canadians who were referred for publicly-funded community mental health counselling in 2023-2024 had a session scheduled within 25 days. One in 10 waited almost five months, or 143 days, or more.
CIHI also found the electronic sharing of health information remains a challenge in Canada, with a 2023 survey showing four in five (81 per cent) of Canadians said they were interested in this method. Only two in five (39 per cent) had done so.
The report says 48 per cent of older Canadians, age 65 and above, have accessed health information online, while only 30 per cent of younger adults, age 18 to 24, have done the same.
This year, about one in three (29 per cent) of physicians reported they shared patient information electronically with health providers outside of their own practice.