Canada ranks last among wealthy nations for access to primary health care

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Canada ranked in the middle of the pack for access to a primary care provider in 2016. The country’s position plummeted to last in 2023, according to the Commonwealth Fund survey of 10 countries high income

The Commonwealth Funds International Health Policy Survey looks at the health experiences of the general population aged 18 and over. Aspects such as primary and mental health care, information technology use, prescription drug use, chronic disease care, behavioral factors affecting health and needs are assessed of social services.

The ten countries analyzed were the Netherlands, New Zealand, the United Kingdom, Germany, Australia, Switzerland, France, Sweden, the United States and Canada. An average is obtained for each statistic for the ten countries.

In terms of the proportion of adults who reported having a doctor or a place they regularly went to for medical care in 2016, Canada ranked at 93%, 2% below the average but above Sweden, the United States and Switzerland. The Netherlands also fell between 2016 and 2023, from 100% to 99%.

By 2023, Canada fell to 86% in this category, 7% below the average and below all countries.

That means an estimated 4 million Canadian adults did not have a primary care provider by 2023, read the report.

The survey looked at several different demographics of the Canadian population. Earnings were split, increasing every $30,000 earned. Those earning less than $30,000 had the least amount of access, 81 percent, while those earning more than $150,000 a year had the highest, 93 percent. The percentage increased with each incremental gain.

Three age groups were also identified. Ages were divided into 18-34, 35-64 and 65+. Again, the percentage of Canadians who reported having a doctor or a place they usually go to for medical care increased with each increment. While only 78% of Canadians aged 18 to 34 said they did have a regular doctor, 93% of those aged 65 and over did.

90% of women had access to a regular doctor, while only 82% of men said the same.

Of Canadians without a regular primary care provider, 39 per cent reported having at least one chronic health condition and 29 per cent took one or more prescription drugs, the report found.

When it came to the share of adults who reported being able to get same-day or next-day appointments to see a doctor or nurse when they were sick or needed medical care, Canada again ranked last by a wide margin . Only 26% of Canadians were able to get same-day or next-day appointments, 16% below the CMWF average of 42% and 9% below second-place New Zealand.

The number of Canadians able to get same-day or next-day appointments decreased by 20% between 2016 and 2023, from 46% to 26%.

Respondents were asked whether receiving medical care at night, on weekends or on holidays was easy or somewhat easy. 23% of Canadians said yes, 9% below the average of 32%. Only two countries, the United Kingdom and Sweden, were below Canada in this respect. The Netherlands led the group with 56%.

In 2016, 35% of Canadians thought it was very or somewhat easy to get medical appointments at night, on weekends or on holidays.

Despite the challenge of accessing primary care, the data revealed that Canadian patients feel they have more positive experiences with their health care providers.

The survey also included experiences of whether Canadians felt they were treated with courtesy and respect, received clear explanations, participated in health care decisions, understood their medical history well, received help coordinating the ‘care from other providers and felt they received enough time with their doctors.

Canada ranked above average in each of the six categories.


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