Article Figures & Tables
Figures
- Figure 1:
Patient cohort flowchart. Note: HCES= Health Care Experiences Survey.
- Figure 2:
Patient-reported access (2013 to 2017), namely (A) telephone access (n = 10 968), (B) after-hours access (n = 18 889), (C) wait time for care (n = 9485) and (D) timeliness of wait for care (n = 3048) from Health Care Experiences Survey. “Timeliness” reflects survey responses from April 2016 to 2017. Note: RIO = Rurality Index of Ontario.
- Figure 3:
Multilevel univariate regression analysis of the odds of the patient reporting favourable (A) telephone access, (B) after-hours access, (C) wait time for care and (D) timeliness of wait for care, by geography and physician bonus quintile (Q1 = reference [lowest] quintile). Note: CI = confidence interval, OR = odds ratio.
- Figure 4:
Multilevel multivariable logistic regression analysis of the odds of the patient reporting favourable (A) telephone access, (B) after-hours access, (C) wait time for care and (D) timeliness of wait for care, by geography and physician bonus quintile (Q1 = reference [lowest] quintile). Note: CI = confidence interval, OR = odds ratio.
Tables
- Table 1:
Patient-reported access variables and coding schemes from the Health Care Experiences Survey (HCES)
Variable HCES question stem Coding scheme for answer choices Telephone access (HCES item access 2) How often did your provider or someone else in the office speak to you when you called or get back to you the same day?† Favourable: Always, often
Unfavourable: Sometimes, rarely, never, volunteers “it depends”
Missing: Don’t know, refusedAfter-hours access (HCES item access 6) Not including hospital emergency departments, does your provider have an after-hours clinic where patients can be seen by or talk to a doctor or nurse when the provider’s office is closed? Favourable: Yes
Unfavourable: No, Don’t know
Missing: RefusedWait time for care (HCES item sick 3) How many days did it take from when you first tried to see your provider to when you actually saw them or someone else in their office?‡ Favourable: Same day, next day
Unfavourable: 2 to ≥ 20 days
Missing: Don’t know, refusedTimeliness of wait for care (HCES item sick 6)* Would you say the length of time it took between making the appointment and the actual visit was about right, somewhat too long or much too long?‡ Favourable: About right
Unfavourable: Somewhat too long, much too long
Missing: Other, don’t know, refused↵* Added to survey in April 2016.
↵† Asked only of participants answering “Yes” to the question, “Have you called or tried to call your provider’s office with a medical question or concern during the day on a Monday to Friday in the last 12 months?”
↵‡ Asked only of participants answering “Yes” to the question, “Not counting yearly check-ups or monitoring of an ongoing health issue, in the last 12 months did you want to see your provider because you were sick or had a health concern?”
Variable No. (%) of patients Total sample (RIO 0–39) (n = 18 893) Large urban (RIO 0) (n = 8325) Medium urban (RIO 1–9) (n = 6214) Small urban (RIO 10–39) (n = 4354) Sex (n = 18 893) Female 11 278 (59.7) 5066 (60.9) 3664 (59.0) 2548 (58.5) Male 7615 (40.3) 3259 (39.2) 2550 (41.0) 1806 (41.5) Age, yr (n = 18 893) 16–18 374 (2.0) 168 (2.0) 118 (1.9) 88 (2.0) 19–34 2444 (12.9) 1089 (13.1) 871 (14.0) 484 (11.1) 35–49 4562 (24.2) 2138 (25.7) 1528 (24.6) 896 (20.6) 50–64 5859 (31.0) 2500 (30.0) 1925 (31.0) 1434 (32.9) 65–74 3436 (18.2) 1469 (17.7) 1079 (17.4) 888 (20.4) ≥ 75 2218 (11.7) 961 (11.5) 693 (11.2) 564 (13.0) Language (n = 18 815) English, English & French, English & other 17 294 (91.9) 7406 (89.5) 5719 (92.4) 4169 (96.0) French 436 (2.3) 170 (2.1) 160 (2.6) 106 (2.4) Other 1085 (5.8) 703 (8.5) 313 (5.16) 69 (1.6) Education (n = 18 749) Some high school or less 1998 (10.7) 720 (8.7) 662 (10.7) 616 (14.3) High school 3760 (20.1) 1431 (17.3) 1266 (20.5) 1063 (24.6) Some postsecondary 1652 (8.8) 689 (8.3) 569 (9.2) 394 (9.1) College 4868 (26.0) 1949 (23.6) 1660 (26.9) 1259 (29.2) University 4304 (23.0) 2185 (26.5) 1410 (22.8) 709 (16.4) Postgraduate 2167 (11.6) 1283 (15.5) 606 (9.8) 278 (6.4) Income quintile (n = 18 836) 1 (lowest) 2854 (15.2) 1349 (16.3) 865 (14.0) 640 (14.7) 2 3327 (17.7) 1519 (18.3) 986 (15.9) 822 (18.9) 3 3795 (20.2) 1659 (20.0) 1207 (19.5) 929 (21.4) 4 4257 (22.6) 1765 (21.3) 1467 (23.7) 1025 (23.6) 5 (highest) 4603 (24.4) 2000 (24.1) 1678 (27.1) 925 (21.3) Immigrant* (n = 18 822) Yes 4096 (21.8) 2312 (27.9) 1266 (20.4) 518 (11.9) No 14 726 (78.2) 5965 (72.1) 4933 (79.6) 3828 (88.1) Self-reported general health (n = 18 818) Poor 781 (4.2) 307 (3.7) 259 (4.2) 215 (5.0) Fair 2087 (11.1) 904 (10.9) 682 (11.0) 501 (11.6) Good 5290 (28.1) 2258 (27.2) 1808 (29.2) 1224 (28.2) Very good 7129 (37.9) 3164 (38.2) 2353 (11.0) 1622 (37.4) Excellent 3531 (18.8) 1655 (20.0) 1101 (4.2) 775 (17.9) Note: RIO = Rurality Index of Ontario.
↵* Mean years since immigration: large urban 34.29 (standard deviation [SD] 18.54) years, medium urban 37.95 (SD 19.15) years, small urban 44.58 (SD 17.42) years.
Variable No. (%) of practices* Total sample (RIO 0–39)
n = 414Large urban (RIO 0)
n = 210Medium urban (RIO 1–9)
n = 130Small urban (RIO 10–39)
n = 74Not team-based practice 277 (66.9) 142 (67.6) 100 (76.9) 35 (47.3) Team-based practice 137 (33.1) 68 (32.4) 30 (23.1) 39 (52.7) No. of physicians per practice, mean ± SD (n = 414) 10 (9.6) 11 (9.4) 9 (8.0) 12 (12.2) No. of after-hours services per year, mean ± SD (n = 400) 3935 ± 4797 3962 ± 4760 3924 ± 3662 3876 ± 6347 Note: RIO = Rurality Index of Ontario, SD = standard deviation.
↵* Unless indicated otherwise.
Variable No. (%) of physicians* Total sample (RIO 0–39)
n = 3940Large urban (RIO 0)
n = 2026Medium urban (RIO 1–9)
n = 1222Small urban (RIO 10–39)
n = 692Age, yr, mean ± SD (n = 3940) 51.9 ± 11.4 51.6 ± 11.7 51.8 ± 11.0 53.0 ± 10.9 Years in practice, mean ± SD (n = 3938) 26.8 ± 3.2 26.7 ± 3.0 26.8 ± 3.2 27.0 ± 3.6 Roster size, mean ± SD (n = 3940) 1522 ± 639 1435 ± 658 1638 ± 604 1571 ± 605 Proportion (%) of maximum potential access bonus achieved, mean ± SD (n = 3940) 40.26 ± 30.67 32.86 ± 28.39 40.63 ± 30.30 61.23 ± 27.87 Sex (n = 3940) Female 1872 (47.5) 1100 (54.3) 535 (43.8) 237 (34.3) Male 2068 (52.5) 926 (45.7) 687 (56.2) 455 (65.8) Canadian graduate (n = 3938) No 907 (23.0) 416 (20.5) 328 (26.8) 163 (23.6) Yes 3031 (77.0) 1608 (79.4) 894 (73.2) 529 (76.4) Access bonus achievement by quintile 1 (lowest) 877 (22.3) 545 (26.9) 269 (22.0) 63 (9.1) 2 865 (22.0) 554 (27.3) 260 (21.3) 51 (7.4) 3 818 (20.8) 457 (22.6) 253 (20.7) 108 (15.6) 4 726 (18.4) 298 (14.7) 253 (20.7) 175 (25.3) 5 (highest) 654 (16.6) 172 (8.5) 187 (15.3) 295 (42.6) Note: RIO = Rurality Index of Ontario, SD = standard deviation.
↵* Unless indicated otherwise.
- Table 5:
Multilevel multivariable logistic regression for patient-reported telephone access, by geography
Variable OR (95% CI)* Total sample (RIO 0–39) Large urban (RIO 0) Medium urban (RIO 1–9) Small urban (RIO 10–39) Main exposure Access bonus quintile 1 (lowest) Ref. Ref. Ref. Ref. 2 1.18 (0.98–1.42) 1.09 (0.85–1.39) 1.33 (0.99–1.79) 0.77 (0.42–1.42) 3 1.34 (1.10–1.63) 1.17 (0.90–1.53) 1.75 (1.25–2.45) 0.84 (0.48–1.48) 4 1.46 (1.19–1.79) 1.45 (1.06–1.96) 1.75 (1.25–2.44) 1.24 (0.75–2.08) 5 (highest) 1.87 (1.50–2.33) 2.23 (1.52–3.26) 2.39 (1.63–3.50) 1.58 (0.97–2.57) ICC, practice, % 3.26 1.80 2.18 1.78 ICC, physician, % 6.70 6.74 6.52 7.98 Patient, n 10 778 4642 3542 2594 Sex Male Ref. Ref. Ref. Ref. Female 0.99 (0.89–1.10) 1.05 (0.89–1.25) 0.96 (0.80–1.16) 0.94 (0.75–1.18) Age, yr < 18 Ref. Ref. Ref. Ref. 19–34 0.84 (0.50–1.39) 1.20 (0.56–2.54) 0.99 (0.41–2.36) 0.33 (0.09–1.22) 35–49 0.88 (0.53–1.45) 1.16 (0.55–2.42) 1.08 (0.46–2.54) 0.35 (0.10–1.28) 50–64 0.94 (0.57–1.54) 1.23 (0.59–2.57) 1.10 (0.47–2.57) 0.42 (0.12–1.53) 65–74 1.56 (0.94–2.58) 2.14 (1.01–4.52)* 1.79 (0.76–4.25) 0.69 (0.19–2.54) ≥ 75 1.40 (0.84–2.34) 1.35 (0.64–2.88) 2.03 (0.84–4.93) 0.74 (0.20–2.78) Education Some high school or less Ref. Ref. Ref. Ref. High School 1.32 (1.07–1.63) 1.34 (0.93–1.93) 1.3 (0.90–1.87) 1.29 (0.87–1.91) Some postsecondary 1.37 (1.07–1.76) 1.25 (0.83–1.88) 1.76 (1.14–2.72) 1.00 (0.63–1.59) College 1.18 (0.96–1.46) 1.24 (0.87–1.77) 1.26 (0.88–1.80) 0.99 (0.67–1.44) University 1.17 (0.94–1.45) 1.09 (0.77–1.56) 1.24 (0.85–1.80) 1.03 (0.68–1.55) Postgraduate 1.02 (0.80–1.29) 0.98 (0.67–1.43) 1.14 (0.74–1.74) 0.76 (0.46–1.26) Primary language Other Ref. Ref. Ref. Ref. English, English & French, English & other 1.08 (0.84–1.40) 0.94 (0.67–1.32) 1.61 (1.02–2.54) 0.86 (0.31–2.4) French 0.93 (0.61–1.42) 0.72 (0.37–1.39) 1.24 (0.61–2.51) 1.08 (0.31–3.85) Health status Poor Ref. Ref. Ref. Ref. Fair 1.29 (1.01–1.66) 1.37 (0.90–2.08) 1.13 (0.73–1.74) 1.24 (0.77–2.00) Good 1.41 (1.12–1.77) 1.35 (0.91–1.98) 1.46 (0.98–2.17) 1.31 (0.85–2.00) Very good 1.98 (1.57–2.49) 1.97 (1.33–2.90) 1.83 (1.23–2.71) 2.06 (1.34–3.16) Excellent 2.21 (1.72–2.83) 2.30 (1.51–3.49) 1.69 (1.11–2.59) 2.97 (1.82–4.85) Income quintile 1 (lowest) Ref. Ref. Ref. Ref. 2 1.01 (0.85–1.20) 1.10 (0.84–1.44) 0.99 (0.72–1.35) 0.97 (0.68–1.40) 3 1.07 (0.90–1.27) 1.07 (0.82–1.40) 1.20 (0.88–1.62) 0.99 (0.69–1.43) 4 1.00 (0.84–1.18) 1.12 (0.86–1.46) 1.10 (0.82–1.48) 0.84 (0.59–1.19) 5 1.08 (0.91–1.28) 1.11 (0.86–1.45) 1.24 (0.93–1.65) 0.88 (0.61–1.26) Immigrant status Yes Ref. Ref. Ref. Ref. No 1.19 (1.03–1.37) 1.25 (1.02–1.53) 1.12 (0.87–1.44) 1.17 (0.83–1.65) Physician, n 3940 2026 1222 692 Age 1.01 (1.00–1.01) 1.01 (1.00–1.01) 1.01 (1.00–1.02) 1.00 (0.99–1.01) Sex Male Ref. Ref. Ref. Ref. Female 0.98 (0.86–1.11) 0.89 (0.73–1.08) 1.00 (0.81–1.24) 1.00 (0.76–1.33) Canadian graduate No Ref. Ref. Ref. Ref. Yes 1.20 (1.05–1.37) 1.30 (1.04–1.62) 1.27 (1.02–1.58)* 0.87 (0.65–1.17) Years in practice (per 5-yr increase) 0.89 (0.82–0.97) 0.82 (0.72–0.94) 0.96 (0.82–1.11) 0.91 (0.78–1.07) Roster size (per 100-patient increase) 0.92 (0.84–1.01) 0.88 (0.76–1.02) 0.94 (0.81–1.10) 1.00 (0.82–1.23) Practice, n 414 210 130 74 Group size (per 10-member increase) 1.03 (0.96–1.10) 1.05 (0.95–1.16) 0.91 (0.81–1.02) 1.09 (0.96–1.24) Number of after-hours services (per 500-hr increase) 0.96 (0.89–1.04) 0.92 (0.83–1.02) 1.04 (0.92–1.18) 0.99 (0.85–1.14) Practice model Not team-based Ref. Ref. Ref. Ref. Team-based 0.92 (0.79–1.07) 0.86 (0.69–1.07) 1.19 (0.91–1.56) 0.72 (0.53–0.98) Note: CI = confidence interval, ICC = intraclass correlation coefficient, OR = odds ratio, Ref. = reference, RIO = Rurality Index of Ontario.
↵* Unless indicated otherwise.
- Table 6:
Multilevel multivariable logistic regression for patient-reported after-hours access, by geography
Variable OR (95% CI)* Total sample (RIO 0–39) Large urban (RIO 0) Medium urban (RIO 1–9) Small urban (RIO 10–39) Main exposure Access bonus quintile 1 (lowest) Ref. Ref. Ref. Ref. 2 1.26 (1.09–1.47) 1.36 (1.13–1.64) 1.41 (1.07–1.85) 1.18 (0.64–2.19) 3 1.46 (1.23–1.74) 1.84 (1.47–2.30) 1.55 (1.14–2.12) 1.07 (0.58–1.98) 4 1.77 (1.46–2.15) 2.36 (1.81–3.09) 1.95 (1.39–2.73) 1.36 (0.75–2.48) 5 (highest) 1.88 (1.52–2.32) 1.92 (1.39–2.65) 2.50 (1.70–3.68) 1.69 (0.93–3.07) ICC, practice, % 17.25 13.03 17.67 22.85 ICC, physician, % 5.66 4.80 6.99 4.53 Patient, n 10 778 4642 3542 2594 Sex Male Ref. Ref. Ref. Ref. Female 1.57 (1.46–1.68) 1.76 (1.58–1.96) 1.39 (1.23–1.57) 1.54 (1.33–1.79) Age, yr < 18 Ref. Ref. Ref. Ref. 19–34 1.66 (1.26–2.17) 2.04 (1.34–3.08) 1.55 (0.96–2.51) 1.42 (0.81–2.48) 35–49 2.45 (1.88–3.19) 3.13 (2.09–4.69) 2.52 (1.57–4.06) 1.66 (0.96–2.86) 50–64 2.47 (1.90–3.20) 3.06 (2.06–4.57) 2.69 (1.69–4.29 1.59 (0.94–2.71) 65–74 2.38 (1.83–3.10) 3.19 (2.13–4.77) 2.71 (1.69–4.34) 1.35 (0.79–2.32) ≥ 75 1.82 (1.39–2.38) 2.22 (1.47–3.33) 1.84 (1.14–2.97) 1.30 (0.75–2.26) Education Some high school or less Ref. Ref. Ref. Ref. High school 1.13 (0.99–1.28) 1.13 (0.91–1.41) 1.04 (0.83–1.30) 1.19 (0.93–1.51) Some postsecondary 1.13 (0.97–1.33) 1.20 (0.93–1.55) 1.12 (0.85–1.46) 1.01 (0.74–1.37) College 1.29 (1.13–1.48) 1.29 (1.04–1.61) 1.31 (1.04–1.64) 1.25 (0.97–1.60) University 1.28 (1.11–1.47) 1.37 (1.10–1.71) 1.21 (0.95–1.53) 1.15 (0.87–1.52) Postgraduate 1.33 (1.14–1.55) 1.46 (1.15–1.85) 1.13 (0.85–1.49) 1.27 (0.89–1.81) Primary language Other Ref. Ref. Ref. Ref. English, English & French, English & other 1.62 (1.37–1.92) 1.57 (1.26–1.95) 1.81 (1.32–2.48) 1.23 (0.67–2.25) French 1.11 (0.83–1.48) 0.87 (0.57–1.33) 1.43 (0.88–2.33) 0.73 (0.32–1.64) Health status Poor Ref. Ref. Ref. Ref. Fair 1.09 (0.90–1.32) 0.98 (0.72–1.33) 1.21 (0.87–1.69) 0.94 (0.64–1.39) Good 1.05 (0.88–1.26) 1.00 (0.75–1.34) 1.12 (0.83–1.52) 0.89 (0.63–1.26) Very good 1.18 (0.99–1.41) 1.12 (0.84–1.49) 1.21 (0.89–1.64) 1.03 (0.73–1.46) Excellent 1.04 (0.86–1.25) 0.97 (0.72–1.31) 1.04 (0.75–1.43) 0.99 (0.68–1.43) Income quintile 1 (lowest) Ref. Ref. Ref. Ref. 2 1.03 (0.92–1.17) 1.11 (0.93–1.33) 1.03 (0.83–1.28) 0.96 (0.75–1.24) 3 1.09 (0.97–1.22) 0.96 (0.80–1.14) 1.31 (1.07–1.61) 1.17 (0.91–1.49) 4 1.16 (1.03–1.30) 1.19 (1.00–1.41) 1.27 (1.04–1.55) 1.10 (0.87–1.41) 5 1.09 (0.97–1.22) 1.05 (0.89–1.25) 1.25 (1.03–1.53) 1.01 (0.79–1.29) Immigrant status Yes Ref. Ref. Ref. Ref. No 1.24 (1.13–1.36) 1.24 (1.09–1.41) 1.34 (1.13–1.59) 1.17 (0.93–1.48) Physician, n 3940 2026 1222 692 Age 0.99 (0.99–1.00) 1.00 (0.99–1.00) 0.99 (0.99–1.00) 0.99 (0.99–1.00) Sex Male Ref. Ref. Ref. Ref. Female 1 (0.91–1.09) 0.97 (0.85–1.11) 1 (0.85–1.19) 1.12 (0.90–1.38) Canadian graduate No Ref. Ref. Ref. Ref. Yes 1.09 (0.98–1.20) 1.03 (0.88–1.21) 1.11 (0.93–1.33) 1.18 (0.95–1.47) Years in practice (per 5-yr increase) 1.00 (0.94–1.07) 1.07 (0.97–1.18) 0.96 (0.85–1.07) 1.10 (0.98–1.25) Roster size (per 100-patient increase) 0.90 (0.83–0.96) 0.83 (0.74–0.92) 0.92 (0.81–1.04) 1.02 (0.87–1.20) Practice, n 414 210 130 74 Group size (per 10-member increase) 1.12 (1.02–1.23) 1.17 (1.03–1.33)* 1.05 (0.90–1.22) 1.08 (0.87–1.34) Number of after-hours services (per 500-hr increase) 1.00 (0.89–1.12) 0.98 (0.85–1.12) 0.98 (0.83–1.16) 1.05 (0.81–1.36) Practice model Not team-based Ref. Ref. Ref. Ref. Team-based 1.23 (0.99–1.52) 1.47 (1.13–1.93) 1 (0.66–1.51) 1.29 (0.78–2.14) Note: CI = confidence interval, ICC = intraclass correlation coefficient, OR = odds ratio, Ref. = reference, RIO = Rurality Index of Ontario.
↵* Unless indicated otherwise.
- Table 7:
Multilevel multivariable logistic regression for patient-reported wait time for care, by geography
Variable OR (95% CI)* Total sample (RIO 0–39) Large urban (RIO 0) Medium urban (RIO 1–9) Small urban (RIO 10–39) Main exposure Access bonus quintile 1 (lowest) Ref. Ref. Ref. Ref. 2 1.01 (0.85–1.20) 1.11 (0.89–1.37) 0.98 (0.73–1.32) 0.65 (0.32–1.3) 3 1.17 (0.97–1.41) 1.29 (1.02–1.64) 1.05 (0.75–1.47) 1.00 (0.54–1.83) 4 1.27 (1.05–1.55) 1.32 (1.01–1.72) 1.66 (1.18–2.35) 1.30 (0.75–2.25) 5 (highest) 1.63 (1.32–2.00) 2.00 (1.46–2.73) 2.15 (1.46–3.14) 1.56 (0.93–2.63) ICC, practice, % 4.87 3.27 4.98 1.20 ICC, physician, % 6.16 4.77 4.96 12.35 Patient, n 10 778 4642 3542 2594 Sex Male Ref. Ref. Ref. Ref. Female 1.12 (1.02–1.23) 1.13 (0.98–1.31) 1.18 (0.99–1.40) 1.08 (0.87–1.34) Age, yr ≤ 18 Ref. Ref. Ref. Ref. 19–34 1.50 (1.01–2.23) 1.60 (0.90–2.84) 1.09 (0.55–2.18) 2.35 (0.92–5.98) 35–49 1.48 (1.01–2.18) 1.34 (0.76–2.33) 1.49 (0.76–2.94) 2.06 (0.83–5.10) 50–64 1.50 (1.02–2.19) 1.45 (0.83–2.52) 1.37 (0.71–2.66) 2.08 (0.85–5.09) 65–74 1.90 (1.30–2.80) 1.87 (1.07–3.28) 1.49 (0.76–2.92) 3.17 (1.28–7.82) ≥ 75 2.13 (1.44–3.16) 2.03 (1.14–3.60) 2.28 (1.15–4.53) 2.56 (1.01–6.48) Education Some high school or less Ref. Ref. Ref. Ref. High school 0.99 (0.82–1.19) 0.94 (0.70–1.27) 1.14 (0.81–1.60) 0.88 (0.61–1.27) Some postsecondary 0.85 (0.68–1.06) 0.83 (0.59–1.17) 0.94 (0.64–1.38) 0.79 (0.50–1.25) College 0.94 (0.78–1.14) 0.96 (0.72–1.29) 1.08 (0.77–1.51) 0.76 (0.52–1.10) University 0.87 (0.72–1.06) 0.90 (0.67–1.20) 0.93 (0.65–1.32) 0.64 (0.43–0.96) Postgraduate 0.80 (0.65–1.00) 0.81 (0.59–1.10) 0.90 (0.60–1.34) 0.65 (0.38–1.11) Primary language Other Ref. Ref. Ref. Ref. English, English & French, English & other 0.88 (0.71–1.10) 0.88 (0.67–1.17) 1.21 (0.80–1.84) 0.71 (0.27–1.83) French 0.68 (0.46–1.01) 0.83 (0.48–1.42) 0.78 (0.36–1.69) 0.58 (0.18–1.92) Health status Poor Ref. Ref. Ref. Ref. Fair 0.92 (0.72–1.17) 0.85 (0.59–1.22) 0.80 (0.52–1.23) 1.21 (0.74–1.98) Good 0.95 (0.76–1.19) 0.89 (0.63–1.25) 0.91 (0.62–1.35) 1.12 (0.71–1.75) Very good 1.16 (0.93–1.44) 0.99 (0.71–1.39) 1.24 (0.84–1.84) 1.29 (0.83–2.02) Excellent 1.30 (1.02–1.65) 1.18 (0.83–1.70) 1.27 (0.83–1.93) 1.38 (0.84–2.29) Income quintile 1 (lowest) Ref. Ref. Ref. Ref. 2 1.05 (0.89–1.23) 1.04 (0.83–1.31) 1.13 (0.83–1.54) 1.04 (0.72–1.49) 3 1.05 (0.90–1.23) 0.96 (0.77–1.21) 1.30 (0.97–1.76) 0.98 (0.68–1.40) 4 1.14 (0.97–1.33) 1.02 (0.81–1.27) 1.33 (1.00–1.78) 1.31 (0.92–1.85) 5 1.17 (1.01–1.37) 1.04 (0.83–1.30) 1.54 (1.16–2.05) 1.10 (0.76–1.57) Immigrant status Yes Ref. Ref. Ref. Ref. No 1.00 (0.88–1.13) 0.98 (0.83–1.17) 0.96 (0.76–1.2) 1.33 (0.94–1.89) Physician, n 3940 2026 1222 692 Age 1.00 (1.00–1.01) 1.00 (1.00–1.01) 1.01 (1.00–1.02) 1.00 (0.99–1.02) Sex Male Ref. Ref. Ref. Ref. Female 0.92 (0.82–1.03) 0.88 (0.75–1.03) 0.94 (0.77–1.16) 0.95 (0.71–1.26) Canadian graduate No Ref. Ref. Ref. Ref. Yes 1.07 (0.94–1.21) 0.93 (0.77–1.12) 1.03 (0.83–1.27) 1.37 (1.01–1.85) Years in practice (per 5-yr increase) 0.90 (0.83–0.98) 1.04 (0.92–1.17) 0.80 (0.69–0.93) 0.84 (0.70–1.01) Roster size (per 100-patient increase) 1.03 (0.94–1.12) 1.13 (0.99–1.28) 0.94 (0.81–1.08) 1.03 (0.83–1.27) Practice, n 414 210 130 74 Group size (per 10-member increase) 0.92 (0.86–0.99) 1.02 (0.93–1.12) 0.80 (0.70–0.91) 0.89 (0.79–1.01) Number of after-hours services (per 500-hr increase) 1.08 (1.00–1.16) 1.05 (0.95–1.16) 1.12 (0.99–1.28) 1.13 (0.99–1.31) Practice model Not team-based Ref. Ref. Ref. Ref. Team-based 1.1 (0.94–1.28) 1.13 (0.92–1.38) 1.27 (0.96–1.69) 0.96 (0.71–1.31) Note: CI = confidence interval, ICC = intraclass correlation coefficient, OR = odds ratio, Ref. = reference, RIO = Rurality Index of Ontario.
↵* Unless indicated otherwise.
- Table 8:
Multilevel multivariable logistic regression for patient-reported timeliness of wait, by geography
Variable OR (95% CI)* Total sample (RIO 0–39) Large urban (RIO 0) Medium urban (RIO 1–9) Small urban (RIO 10–39) Main exposure Access bonus quintile 1 (lowest) Ref. Ref. Ref. Ref. 2 1.29 (0.98–1.69) 1.13 (0.77–1.68) 1.48 (0.85–2.58) 0.87 (0.24–3.08) 3 1.29 (0.94–1.77) 0.96 (0.61–1.52) 2.15 (1.16–3.99) 1.62 (0.48–5.44) 4 1.58 (1.16–2.13) 1.39 (0.81–2.36) 2.39 (1.32–4.31) 1.62 (0.58–4.52) 5 (highest) 1.98 (1.38–2.82) 3.01 (1.42–6.38) 1.99 (1.01–3.90) 2.26 (0.83–6.14) ICC, practice, % 1.89 3.61 1.30 0.98 ICC, physician, % 7.93 6.64 9.95 15.61 Patient, n 10 778 4642 3542 2594 Sex Male Ref. Ref. Ref. Ref. Female 0.83 (0.7–1.00) 0.99 (0.74–1.33) 0.7 (0.49–0.98) 0.67 (0.37–1.19) Age, yr ≤ 18 Ref. Ref. Ref. Ref. 19–34 0.44 (0.16–1.24) 0.41 (0.06–2.65) 0.29 (0.04–2.05) 1.10 (0.08–15.61) 35–49 0.48 (0.16–1.40) 0.41 (0.06–2.77) 0.45 (0.06–3.43) 0.79 (0.05–12.52) 50–64 0.58 (0.20–1.66) 0.66 (0.10–4.38) 0.39 (0.06–2.70) 0.96 (0.06–14.32) 65–74 1.08 (0.38–3.06) 0.99 (0.15–6.54) 0.90 (0.13–6.37) 1.85 (0.12–27.32) ≥ 75 1.17 (0.42–3.28) 0.89 (0.13–5.87) 0.98 (0.14–6.97) 3.88 (0.28–53.10) Education Some high school or less Ref. Ref. Ref. Ref. High school 1.36 (0.93–1.97) 1.85 (1.04–3.28) 1.15 (0.55–2.39) 1.02 (0.37–2.83) Some postsecondary 1.42 (0.91–2.2) 2.03 (0.96–4.32) 1.17 (0.54–2.51) 0.83 (0.23–3.06) College 1.11 (0.79–1.57) 1.57 (0.90–2.71) 0.84 (0.42–1.68) 1.03 (0.38–2.78) University 1.12 (0.79–1.60) 1.72 (0.99–2.98) 0.78 (0.37–1.63) 0.74 (0.27–2.03) Postgraduate 1.18 (0.77–1.80) 1.52 (0.83–2.78) 0.95 (0.38–2.38) 1.04 (0.28–3.81) Primary language Other Ref. Ref. Ref. Ref. English, English & French, English & other 1.41 (0.96–2.08) 1.24 (0.72–2.13) 2.68 (1.09–6.61) 1.44 (0.10–21.36) French 1.3 (0.71–2.40) 1.55 (0.45–5.31) 2.5 (0.61–10.26) 1.20 (0.07–20.91) Health status Poor Ref. Ref. Ref. Ref. Fair 1.00 (0.66–1.51) 1.29 (0.58–2.89) 0.72 (0.34–1.54) 1.01 (0.34–3.05) Good 1.39 (0.94–2.05) 1.42 (0.66–3.04) 1.32 (0.63–2.80) 1.39 (0.42–4.61) Very good 1.48 (0.99–2.22) 1.81 (0.83–3.94) 1.36 (0.67–2.76) 1.11 (0.35–3.55) Excellent 2.02 (1.31–3.10) 1.79 (0.82–3.91) 2.39 (1.05–5.46) 2.57 (0.67–9.82) Income quintile 1 (lowest) Ref. Ref. Ref. Ref. 2 0.99 (0.71–1.37) 0.95 (0.54–1.67) 1.15 (0.64–2.09) 1.09 (0.46–2.58) 3 1.23 (0.91–1.66) 0.86 (0.55–1.36) 2.00 (1.04–3.83) 1.87 (0.75–4.65) 4 0.99 (0.76–1.29) 0.99 (0.66–1.49) 1.31 (0.77–2.21) 0.80 (0.34–1.89) 5 0.97 (0.74–1.26) 0.89 (0.58–1.38) 1.07 (0.60–1.91) 1.13 (0.51–2.49) Immigrant status Yes Ref. Ref. Ref. Ref. No 1.15 (0.90–1.47) 1.45 (1.03–2.02) 0.68 (0.38–1.20) 1.63 (0.74–3.62) Physician, n 3940 2026 1222 692 Age 1.01 (1.00–1.02) 1.01 (0.99–1.02) 1.01 (0.99–1.03) 1.03 (1.00–1.06) Sex Male Ref. Ref. Ref. Ref. Female 1.03 (0.84–1.25) 0.89 (0.66–1.21) 1.57 (1.04–2.37) 0.69 (0.35–1.35) Canadian graduate No Ref. Ref. Ref. Ref. Yes 1.05 (0.85–1.31) 0.94 (0.66–1.33) 1.28 (0.83–1.98) 0.87 (0.44–1.74) Years in practice (per 5-yr increase) 0.91 (0.78–1.05) 0.97 (0.74–1.27) 0.96 (0.72–1.27) 0.77 (0.55–1.08) Roster size (per 100-patient increase) 0.85 (0.74–0.98) 0.92 (0.74–1.16) 0.95 (0.74–1.21) 0.62 (0.37–1.03) Practice, n 414 210 130 74 Group size (per 10-member increase) 0.89 (0.83–0.96) 0.94 (0.82–1.08) 0.79 (0.67–0.92) 0.88 (0.72–1.09) Number of after-hours services (per 500-hr increase) 1.13 (1.01–1.25) 1.02 (0.90–1.15) 1.21 (0.99–1.49) 1.32 (1.02–1.70) Practice model Not team-based Ref. Ref. Ref. Ref. Team-based 1.27 (1.02–1.59) 1.29 (0.89–1.87) 1.40 (0.90–2.19) 1.19 (0.65–2.18) Note: CI = confidence interval, ICC = intraclass correlation coefficient, OR = odds ratio, Ref. = reference, RIO = Rurality Index of Ontario.
↵* Unless indicated otherwise.
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