PT  - JOURNAL ARTICLE
AU  - Rahman, Bahram
AU  - Costa, Andrew P.
AU  - Gayowsky, Anastasia
AU  - Rahim, Ahmad
AU  - Kiran, Tara
AU  - Ivers, Noah
AU  - Price, David
AU  - Jones, Aaron
AU  - Lapointe-Shaw, Lauren
TI  - The association between patients’ timely access to their usual primary care physician and use of walk-in clinics in Ontario, Canada: a cross-sectional study
AID  - 10.9778/cmajo.20220231
DP  - 2023 Sep 01
TA  - CMAJ Open
PG  - E847--E858
VI  - 11
IP  - 5
4099  - http://www.cmajopen.ca/content/11/5/E847.short
4100  - http://www.cmajopen.ca/content/11/5/E847.full
SO  - CMAJ2023 Sep 01; 11
AB  - Background: Challenges in timely access to one’s usual primary care physician and the ongoing use of walk-in clinics have been major health policy issues in Ontario for over a decade. We sought to determine the association between patient-reported timely access to their usual primary care physician or clinic and their use of walk-in clinics.Methods: We conducted a cross-sectional study of Ontario residents who had a primary care physician by linking population-based administrative data to Ontario’s Health Care Experience Survey, collected between 2013 and 2020. We described sociodemographic characteristics and health care use for users of walk-in clinics and nonusers. We measured the adjusted association between self-reported same-day or next-day access and after-hours access to usual primary care physicians or clinics and the use of walk-in clinics in the previous 12 months.Results: Of the 60 935 total responses from people who had a primary care physician, 16 166 (weighted 28.6%, unweighted 26.5%) reported visiting a walk-in clinic in the previous 12 months. Compared with nonusers, those who used walk-in clinics were predominantly younger, lived in large and medium-sized urban areas and reported a tight, very tight or poor financial situation. Respondents who reported poor same-day or next-day access to their primary care physician or clinic were more likely to report having attended a walk-in clinic in the previous 12 months than those with better access (adjusted odds ratio [OR] 1.23, 95% confidence interval [Cl] 1.13–1.34). Those who reported being unaware that their primary care physician offered after-hours care had a higher likelihood of going to a walk-in clinic (adjusted OR 1.14, 95% Cl 1.07–1.21).Interpretation: In this population-based health survey, patient-reported use of walk-in clinics was associated with a reported lack of access to same-day or next-day care and unawareness of after-hours care by respondents’ usual primary care physicians. These findings could inform policies to improve access to primary care, while preserving care continuity.