Our analyses of data on Ontarians with chronic health conditions demonstrate that the majority of these people— 90 to 95 percent—reported having a regular medical doctor at the time they were surveyed. The patterns of care we observed in this group suggest they experienced few serious access barriers to primary care.
However, among the remaining minority of people with chronic conditions, we were able to link three specifi c patient groups with potentially avoidable and costly demands on the health care system. These included thousands of excess ED visits and thousands of excess medical non-elective hospital admissions. Such potentially avoidable ED visits and hospital admissions contribute to the crowding of EDs and to hospital bed shortages. They are also highly likely to be associated with preventable suffering and clinical deterioration which can sometimes be irreversible.
We believe that all three patient groups—those who did not have a regular medical doctor; those whose records showed relatively few physician visits in the previous two years; and those whose pattern of health system usage suggested low continuity of care—represent Ontarians with chronic illness who are having trouble accessing primary care.
We also believe that, given these impacts on health services and on people, implementing policies to address the current shortage of primary health care physicians in Ontario should be seen as a top health system priority.