Sociodemographic differences in patient experience with primary care during COVID-19: results from a cross-sectional survey in Ontario, Canada
Tara Kiran,
Noor Ramji,
Ri Wang,
Payal Agarwal,
Christopher Meaney,
Thuy-Nga Pham,
Sakina Walji,
Ali Damji,
Navsheer Gill,
Gina Yip,
Debbie Elman,
Tiffany Florindo,
Susanna Fung,
Melissa Witty
Affiliations
Tara Kiran
8 Department of Family and Community Medicine, St Michael`s Hospital, University of Toronto, Toronto, Ontario, Canada
Noor Ramji
Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada
Ri Wang
MAP Centre for Urban Health Solutions, St Michael`s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
Payal Agarwal
Institute for Health Systems Solutions and Virtual Care, Women`s College Hospital, Toronto, Ontario, Canada
Christopher Meaney
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Thuy-Nga Pham
1Department of Family and Community Medicine and the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
Sakina Walji
Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada
Ali Damji
Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Navsheer Gill
Department of Family and Community Medicine, Southlake Regional Health Centre, Newmarket, Ontario, Canada
Gina Yip
Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Debbie Elman
Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Tiffany Florindo
Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Susanna Fung
Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Melissa Witty
Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Purpose We sought to understand patients’ care-seeking behaviours early in the pandemic, their use and views of different virtual care modalities, and whether these differed by sociodemographic factors.Methods We conducted a multisite cross-sectional patient experience survey at 13 academic primary care teaching practices between May and June 2020. An anonymised link to an electronic survey was sent to a subset of patients with a valid email address on file; sampling was based on birth month. For each question, the proportion of respondents who selected each response was calculated, followed by a comparison by sociodemographic characteristics using χ2 tests.Results In total, 7532 participants responded to the survey. Most received care from their primary care clinic during the pandemic (67.7%, 5068/7482), the majority via phone (82.5%, 4195/5086). Among those who received care, 30.53% (1509/4943) stated that they delayed seeking care because of the pandemic. Most participants reported a high degree of comfort with phone (92.4%, 3824/4139), video (95.2%, 238/250) and email or messaging (91.3%, 794/870). However, those reporting difficulty making ends meet, poor or fair health and arriving in Canada in the last 10 years reported lower levels of comfort with virtual care and fewer wanted their practice to continue offering virtual options after the pandemic.Conclusions Our study suggests that newcomers, people living with a lower income and those reporting poor or fair health have a stronger preference and comfort for in-person primary care. Further research should explore potential barriers to virtual care and how these could be addressed.