Primary care for all: lessons for Canada from peer countries with high primary care attachment

• Published in: Canadian Medical Association journal (CMAJ) Vol. 195; no. 47; pp. E1628 - E1636
• Main Authors: Shahaed, Heba, Glazier, Richard H, Anderson, Michael, Barbazza, Erica, Bos, Véronique L L C, Saunes, Ingrid S, Auvinen, Juha, Daneshvarfard, Maryam, Kiran, Tara
• Format: Journal Article
• Language: English
• Published: Canada CMA Impact Inc 04-12-2023; CMA Impact, Inc
• Subjects: Access control; Canada; Chronic illnesses; Clinics; Emergency medical care; Family medicine; Family physicians; Health care access; Health care industry; Health facilities; Health insurance; Hospitals; Humans; Medical students; Nurses; Pandemics; Patients; Peer Group; Per capita; Primary care; Primary Health Care; Primary nursing; Quality management; Type 2 diabetes; Canada; United Kingdom; Netherlands; France; Norway; Finland; New Zealand; United Kingdom > UK; Denmark
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.221824

Health systems with strong primary care have better outcomes, lower costs and better equity. Yet, even at the outset of the COVID-19 pandemic, about 17% of people in Canada reported not having a regular primary care clinician. At the same time, Canada is seeing declining enrolment in family medicine as a specialty among medical students, and more graduating family physicians are choosing not to practice generalist office-based care. The pandemic added further strain, spurring some family physicians to retire early, a phenomenon not unique to Canada. To distill lessons for Canadian policy on primary care, they identified Organization for Economic Co-operation and Development (OECD) countries with historically high rates of primary care attachment, compared related health system factors and identified strategies these countries use to achieve high attachment. These lessons range from how health systems are organized to specifics on how primary care is funded, supported and kept accountable. They define primary care attachment as a patient's perception of whether they have a regular primary care clinician or primary care practice where they get care.