Evidence map›Paper›PMID 39358748›Full record

SynthesisSystematic reviews2024

Social determinants of unmet need for primary care: a systematic review.

Feben W Alemu, Jane Yuan, Seth Kadish, Surim Son, Sunbal Salim Khan, Safa M Nulla, Kathryn Nicholson, Piotr Wilk, Jane S Thornton, Shehzad Ali

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Systematic reviews, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing 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

12 citing papers in PubMed.

  1. Review
  2. Article
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. 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

10 authors.

Feben W AlemuDepartment of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada.
Jane YuanDepartment of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada.
Seth KadishDepartment of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada.
Surim SonDepartment of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada.
Sunbal Salim KhanDepartment of Medical Sciences, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Safa M NullaDepartment of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, Canada.
Kathryn NicholsonDepartment of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada.
Piotr WilkDepartment of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada.
Jane S Thornton *Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada.
Shehzad Ali *Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada. shehzad.ali@uwo.ca.ORCID 0000-0002-8042-3630

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite primary care being largely free at the point of delivery, many Canadians experience challenges in accessing the services they need. A systematic review was conducted to summarize the evidence on the level of unmet need for primary care in Canada and its social determinants.

methodsMEDLINE, Embase, Cochrane, and Web of Science databases were screened from inception to December 2023 using relevant search terms for primary care and unmet healthcare needs. Quantitative observational studies in the English language that included Canadian adults aged 18 years and older and focused on unmet needs for primary care were included. The risk of bias in the studies was assessed using either the Joanna Briggs Institute (JBI) critical appraisal checklist or the Newcastle-Ottawa Scale. The included studies were synthesized narratively.

resultsForty-six studies met the inclusion criteria for this review. Of the included studies, 96% were cross-sectional in design and 91% had low risk of bias. The prevalence of unmet need, mostly self-reported, varied between 6.6% and 25.2% in national studies. Social determinants of unmet needs were heterogeneous across studies. Findings suggest that unmet need for primary care is related to having low income, mental health diagnoses, and chronic conditions, and negatively associated with older age, having better-perceived health, and having a family physician.

conclusionsUniversal access to primary care is the founding principle of the Canadian healthcare system. However, we found evidence suggesting that the extent to which primary care needs are met is influenced by social determinants of health. Further research is needed to improve our understanding of the mechanisms of unmet primary care needs in Canada. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021285074.

Indexed as

Health Services AccessibilityHealth Services Needs and DemandPrimary Health CareSocial Determinants of HealthCanadaHumansHealthcare utilizationHealth inequitiesPrimary careSystematic reviewUnmet need

Identifiers

PMID39358748
PMCPMC11448019

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.