Social and health determinants of wait times for primary care in Canada

Objective To identify social and health determinants affecting wait times for primary care in Canada. Design Secondary analysis of national survey data. Setting Canada. Participants Canadian Community Health Survey participants aged 18 years or older during the 2015, 2016, and 2019 cycles. Main outcome measures Weighted summary statistics and a partial proportional odds regression model were used to assess relationships between patient-level social and health determinants and wait times for primary care (ranging from same-day appointments to waits of 1 month or longer). Results A weighted sample of 9,380,662 participants across the 3 survey cycles was used. Participants had a mean age of 49.7 years (standard deviation=17.5), 55.7% were female, and 74.7% were white. Approximately 57.4% of participants waited less than a week for care while 11.0% waited 1 month or longer. Factors associated with higher odds of waiting at least 1 month for a consultation were attaining only a high school diploma (adjusted odds ratio [aOR]=1.12, 95% CI 1.01 to 1.23) compared with having postsecondary education; identifying as Asian (aOR=1.42, 95% CI 1.20 to 1.67) or Black (aOR=1.57, 95% CI 1.16 to 2.13) compared with identifying as white; having “excellent” self-reported health status (aOR=1.10, 95% CI 1.02 to 1.19) compared with “good” self-reported health; lacking a regular primary care provider (aOR=1.47, 95% CI 1.27 to 1.71) compared with having a regular provider; or being classified as having multimorbidity (aOR=1.11, 95% CI 1.01 to 1.21) compared with having no chronic condition. Conclusion Wait times for primary care were found to be associated with patient-level social and health determinants including race, education level, absence or presence of a regular health care provider, self-reported health status, and multimorbidity. Future research could investigate health system determinants of wait times to inform specific policy measures designed to reduce disparities in access to care.