To improve primary care, Canada can learn from Organisation for Economic Co-operation and Development (OECD) countries with high rates of patients attached to primary care clinicians, write authors in an analysis in CMAJ ( Canadian Medical Association Journal ) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.221824 .
It is well known in Canada that there is a crisis in primary care, with about 17% of people reporting that they were without a regular primary care clinician before the COVID-19 pandemic. The pandemic made the situation worse, with some family physicians retiring early, a situation common in other countries also.
The authors looked at 9 countries where more than 95% of people have a family doctor, primary care clinician or place of care, including France, Germany, New Zealand, United Kingdom, Denmark, Netherlands, Finland, Italy and Norway, and consider lessons for Canada.
Canada's health spending was in the middle of the pack, although the percentage of health spending that was public was the lowest at 70%, a figure unchanged since the 1990s. Canada had similar numbers of family physicians per capita but the lowest number of total physicians per capita and spent less of the total health budget on primary care.
"Other countries have designed their system so that everyone has access to primary care. We need to do the same," says Dr. Tara Kiran, a family physician at St. Michael's Hospital, Unity Health Toronto and the Fidani Chair of Improvement and Innovation at the University of Toronto. "At the core, we need to guarantee access to primary care and increase how much we spend on it."
Historical factors, such as physicians negotiating to remain autonomous at introduction of Medicare, have also affected Canada's health system.
Key lessons for Canada:
"These international examples can inform bold policy reform in Canada to advance a vision of primary care for all," the authors conclude.
Canadian Medical Association Journal
People
Primary care for all: lessons for Canada from peer countries with high primary care attachment"
4-Dec-2023