ArticleInternational journal for equity in health2018
Area deprivation and attachment to a general practitioner through centralized waiting lists: a cross-sectional study in Quebec, Canada.
Article in International journal for equity in health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- The use of centralized waiting lists for attachment to family physicians in Quebec, Canada: predictive factors and association with non-urgent emergency department use.BMC health services research · 2026Article
- Trends in access to primary care among Canadian older adults before, during, and following the COVID-19 public health emergency.Scientific reports · 2025Article
- Social and health determinants of wait times for primary care in Canada.Canadian family physician Medecin de famille canadien · 2025Article
- Retaining doctors in organisations in socioeconomically deprived areas in England: a qualitative study.BMJ open · 2025Article
- Toward a universal definition of provider-patient attachment in primary care.Canadian family physician Medecin de famille canadien · 2024Review
- Redirection of low-acuity emergency department patients to nearby medical clinics using an electronic medical support system: effects on emergency department performance indicators.BMC emergency medicine · 2024Observational
- Associations between gentrification, census tract-level socioeconomic status, and cycling infrastructure expansions in Montreal, Canada.SSM - population health · 2024Article
- Telephone outreach by volunteer navigators: a theory-based evaluation of an intervention to improve access to appropriate primary care.BMC primary care · 2023Article
- Saying and doing are different things: a scoping review on how health equity is conceptualized when considering healthcare system performance.International journal for equity in health · 2023Article
- Article
- Article
- Healthcare Use in the Year Following Bronchiolitis Hospitalization.Hospital pediatrics · 2022Observational
- Improved access to and continuity of primary care after attachment to a family physician: longitudinal cohort study on centralized waiting lists for unattached patients in Quebec, Canada.BMC primary care · 2022Observational
- Article
- Expectations and needs of socially vulnerable patients for navigational support of primary health care services.BMC health services research · 2021Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccess to primary healthcare is an important social determinant of health and having a regular general practitioner (GP) has been shown to improve access. In Canada, socio-economically disadvantaged patients are more likely to be unattached (i.e. not have a regular GP). In the province of Quebec, where over 30% of the population is unattached, centralized waiting lists were implemented to help patients find a GP. Our objectives were to examine the association between social and material deprivation and 1) likelihood of attachment, and 2) wait time for attachment to a GP through centralized waiting lists.
methodsA cross-sectional study was conducted in five local health networks in Quebec, Canada, using clinical administrative data of patients attached to a GP between June 2013 and May 2015 (n = 24, 958 patients) and patients remaining on the waiting list as of May 2015 (n = 49, 901), using clinical administrative data. Social and material area deprivation indexes were used as proxies for patients' socio-economic status. Multiple regressions were carried out to assess the association between deprivation indexes and 1) likelihood of attachment to a GP and 2) wait time for attachment. Analyses controlled for sex, age, local health network and variables related to health needs.
resultsPatients from materially medium, disadvantaged and very disadvantaged areas were underrepresented on the centralized waiting lists, while patients from socially disadvantaged and very disadvantaged areas were overrepresented. Patients from very materially advantaged and advantaged areas were less likely to be attached to a GP than patients from very disadvantaged areas. With the exception of patients from socially disadvantaged areas, all other categories of social deprivation were more likely to be attached to a GP compared to patients from very disadvantaged areas. We found a pro-rich gradient in wait time for attachment to a GP, with patients from more materially advantaged areas waiting less than those from disadvantaged areas.
conclusionOur findings suggest that there are socio-economic inequities in attachment to a GP through centralized waiting lists. Policy makers should take these findings into consideration to adjust centralized waiting list processes to avoid further exacerbation of health inequities.
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