Marshall Emily Gard, Munene Abraham
Department of Family Medicine Primary Care Research Unit, Dalhousie University, 1465 Brenton Street Suite 402, Halifax, NS, B3J 3T4, Canada.
BMC Health Serv Res. 2025 Aug 7;25(1):1038. doi: 10.1186/s12913-025-13166-x.
Primary care providers’ (i.e., physicians and nurse practitioners) perceptions of their availability and accessibility may differ from those of their staff (i.e., clerical or reception staff), who are the gatekeepers to accessing care. The objective of this study is to compare responses of primary care providers and their staff on questions reflecting provider availability and accessibility.
We conducted a population survey within Nova Scotia Canada that included 369 primary health care providers and their staff. Main outcomes measured included whether primary health care providers were accepting new patients, requiring meet-and-greets before accepting new patients, had a one-issue-per-visit policy, and had weekly office-hours.
Among providers, 87% reported accepting new patients whereas only 64% of their staff said that they do ( < 0.001). Rates of unconditionally accepting patients (11% of providers and 10% of staff) did not differ ( = 0.62). Acceptance of opioid-requiring patients was reported by 61% of providers and by 70% of their staff ( = 0.05). Requiring meet-and-greets was reported by 36% of providers and 52% of their staff ( < 0.001). There was no difference on a one-issue-per-visit policy (15% of providers and 16% of staff; = 0.75). The median (IQR) number of hours per week spent working as an office-based primary care provider was 40 (30, 45) reported by the providers and 28.9 (21, 35) reported by staff ( < 0.001).
Discrepancies between providers and staff when describing the same practices suggests that components of availability and accessibility are not uniformly understood. Staff who deal with members of the public seeking a provider may inaccurately indicate a provider’s acceptance of new patients, identifying a need for improved specific communication between providers and their staff.
初级医疗服务提供者（即医生和执业护士）对自身可及性和易获取性的认知可能与他们的工作人员（即文职或接待人员）不同，而这些工作人员是获取医疗服务的把关者。本研究的目的是比较初级医疗服务提供者及其工作人员对反映提供者可及性和易获取性问题的回答。
我们在加拿大新斯科舍省进行了一项人口调查，调查对象包括369名初级医疗服务提供者及其工作人员。测量的主要结果包括初级医疗服务提供者是否接受新患者、在接受新患者之前是否需要见面交流、是否有每次就诊只处理一个问题的政策以及每周的办公时间。
在提供者中，87%报告接受新患者，而其工作人员中只有64%表示他们接受新患者（<0.001）。无条件接受患者的比例（提供者为11%，工作人员为10%）没有差异（=0.62）。61%的提供者和70%的工作人员报告接受需要使用阿片类药物的患者（=0.05）。36%的提供者和52%的工作人员报告需要见面交流（<0.001）。每次就诊只处理一个问题的政策方面没有差异（提供者为15%，工作人员为16%；=0.75）。提供者报告的每周作为基层初级医疗服务提供者工作的小时数中位数（四分位间距）为40（30，45），工作人员报告的为28.9（21，35）（<0.001）。
提供者和工作人员在描述相同做法时存在差异，这表明可及性和易获取性的组成部分并未得到统一理解。与寻求医疗服务提供者的公众打交道的工作人员可能会不准确地表明提供者接受新患者的情况，这表明需要改善提供者与其工作人员之间的具体沟通。
