Evidence map›Paper›PMID 34261726›Full record

ArticleCanadian family physician Medecin de famille canadien2021

Understanding disparities in primary care patient experience.

Adrina Zhong, Sam Davie, Ri Wang, Tara Kiran

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian family physician Medecin de famille canadien, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Social and health determinants of wait times for primary care in Canada.Canadian family physician Medecin de famille canadien · 2025
    Article
  3. Article
  4. Article
  5. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023
    Article
  6. Preventive care recommendations to promote health equity.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023
    Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Adrina ZhongMedical student in the Schulich School of Medicine and Dentistry at Western University in London, Ont, at the time of writing.
Sam DavieQuality Improvement and Decision Support Specialist in the Department of Family and Community Medicine (DFCM) at St Michael's Hospital in Toronto, Ont, at the time of writing.
Ri WangAnalyst at the MAP Centre for Urban Health Solutions in the Li Ka Shing Knowledge Institute at St Michael's Hospital.
Tara KiranVice-Chair of Quality and Innovation in the DFCM at the University of Toronto, Associate Professor in the Faculty of Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto, Scientist in the MAP Centre for Urban Health Solutions at St Michael's Hospital, a staff physician in the DFCM at St Michael's Hospital, and, at the time of writing, was Embedded Clinician Researcher at Health Quality Ontario (now Ontario Health).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo understand disparities in primary care patient experience.

designA serial cross-sectional study was conducted to understand disparities in patient experience at 2 time points (2014 and 2016). Disparities related to age, gender, neighbourhood income, and self-rated health were explored using 3 analytic approaches: stratification, logistic regression, and relative comparison across multiple demographic variables.

settingA multisite family health team in Toronto, Ont.

participantsPatients in the family medicine practice who completed e-mail surveys in 2014 (n = 1171, 19% response rate) and 2016 (n = 1823, 15% response rate).

main outcome measuresPatient-reported access (timely access when sick, access after hours) and patient-centredness (opportunity to ask questions, involvement in care decisions, enough time with provider).

resultsPerformance for all measures improved between 2014 and 2016, with the greatest absolute improvement seen in access after hours (61% in 2014; 75% in 2016). Patients residing in low-income neighbourhoods reported worse patient experiences than those in high-income neighbourhoods did, as did patients with poor versus excellent self-rated health, even after adjustment for other variables. For example, in 2016, 60% of patients residing in low-income neighbourhoods reported timely access when sick versus 70% in high-income neighbourhoods (adjusted odds ratio of 0.67, 95% CI 0.47 to 0.95); 60% of patients with poor or fair self-rated health reported timely access when sick versus 72% with excellent self-rated health (adjusted odds ratio of 0.54, 95% CI 0.35 to 0.84). Comparing across demographic groups, patients with excellent self-rated health and poor or fair self-rated health reported the best and worst experiences, respectively, for all measures. In 2016, the average disparity between subgroups was largest for access after hours.

conclusionIn this setting, patient experience was worse for patients in lower-income neighbourhoods and those with poor or fair self-rated health. Access after hours demonstrated the greatest overall absolute improvement but also the greatest widening of disparities.

Indexed as

Primary Health CareResidence CharacteristicsCross-Sectional StudiesFamily PracticeHumansPatient Outcome Assessment

Identifiers

PMID34261726
PMCPMC8279669

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.