Rush Kathy L, Seaton Cherisse L, Burton Lindsay, Smith Mindy A, Li Eric P H
School of Nursing, University of British Columbia, Okanagan Campus, KelownaBC V1V 1V7, Canada.
Patient Partner, Patient Voices Network, British Columbia, Canada and Department of Family Medicine, Michigan State University, East Lansing, Michigan, United States.
Prim Health Care Res Dev. 2025 Jan 6;26:e1. doi: 10.1017/S1463423624000677.
This study aimed to explore healthcare experiences of rural-living patients both with (attached) and without (unattached) a local primary care provider.
Primary care providers serve a gatekeeping role in the Canadian healthcare system as the first contact for receiving many health services. With the shortage of primary care providers, especially in rural areas, there is a need to explore attached and unattached patient experiences when accessing healthcare.
A cross-sectional survey of rural patients both with (attached) and without (unattached) a primary care provider was conducted July-September 2022. An open-ended question gathered participants' thoughts and experiences with provider shortages.
Overall, 523 (Mean age = 51 years, 75% female) rural British Columbia community members (306 attached; 217 unattached) completed the survey. Despite similar overall health, unattached patients received care less frequently overall compared to attached patients, including less frequent non-urgent and preventive care. The vast majority of attached patients sought care from a regular provider whereas unattached patients were more likely to use walk-in, emergency department, and urgent care and 29% did not seek care at all. Overall, 460 (88.0%) provided a response to the open-ended doctor shortage question. Similar themes were found among both attached and unattached participants and included: i) the ubiquity of the doctor shortage, ii) the precariousness or fluidity of attachment status, and iii) solutions and recommendations. Greater attention is needed on the negative and cyclical impacts provider shortages have for both attached and unattached patients alike.
本研究旨在探索有（有联系）和没有（无联系）当地初级保健提供者的农村患者的就医体验。
在加拿大医疗体系中，初级保健提供者作为获取许多医疗服务的首诊人员，发挥着守门人的作用。由于初级保健提供者短缺，尤其是在农村地区，因此有必要探索有联系和无联系的患者在获取医疗服务时的体验。
2022年7月至9月对有（有联系）和没有（无联系）初级保健提供者的农村患者进行了横断面调查。一个开放式问题收集了参与者对提供者短缺的看法和经历。
总体而言，523名（平均年龄 = 51岁，75%为女性）不列颠哥伦比亚省农村社区成员（306名有联系；217名无联系）完成了调查。尽管总体健康状况相似，但与有联系的患者相比，无联系的患者总体上接受治疗的频率较低，包括非紧急和预防性护理的频率较低。绝大多数有联系的患者向常规提供者寻求治疗，而无联系的患者更有可能使用即时诊所、急诊科和紧急护理，29%的患者根本不寻求治疗。总体而言，460名（88.0%）对开放式医生短缺问题做出了回应。在有联系和无联系的参与者中发现了类似的主题，包括：i）医生短缺的普遍性，ii）联系状态的不稳定或流动性，以及iii）解决方案和建议。需要更加关注提供者短缺对有联系和无联系患者产生的负面和周期性影响。
