Evidence map›Paper›PMID 41519745›Full record

ArticleBMC health services research2026

The use of centralized waiting lists for attachment to family physicians in Quebec, Canada: predictive factors and association with non-urgent emergency department use.

Sarah Adi, Delphine Bosson-Rieutort, Mylaine Breton, Mélanie Ann Smithman, Maude Laberge, Nadia Sourial

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Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

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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

1 citing paper in PubMed.

  1. 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

6 authors.

Sarah AdiDepartment of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, QC, Canada. sarah.adi@umontreal.ca.
Delphine Bosson-RieutortDepartment of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, QC, Canada.
Mylaine BretonDepartment of Community Health Sciences, Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, QC, Canada.
Mélanie Ann SmithmanDepartment of Community Health Sciences, Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, QC, Canada.
Maude LabergeDepartment of social and preventive medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Nadia SourialDepartment of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, QC, Canada.

Funding

CIHR Canada Graduate Scholarships - Master's program (CGS M)
6 · The paper itself

Abstract

backgroundIn Quebec, Canada, more than a quarter of residents are unattached to a family physician (FP). To streamline attachment requests, centralized waiting lists (CWLs) were implemented in the province. However, FPs can still opt for non-CWL attachment, which may contribute to disparities in access to primary care. The objective of this study was to identify predictive factors for the mode of attachment (CWL vs. non-CWL) and to examine its association with the number of non-urgent emergency department (ED) visits.

methodsThis population-based retrospective cohort study (N = 1,417,838) examined adult patients attached to a FP between April 2017 and June 2021 in Quebec, Canada, using administrative data from the Régie de l’assurance maladie du Québec and the Ministry of Health and Social Services. Random forests were used to assess the relative importance of sociodemographic and health factors in predicting the mode of attachment. An adjusted negative binomial model was fitted to estimate the incidence rate ratio (IRR) of non-urgent ED visits, a proxy for unmet access to primary care, in the year following attachment to a FP.

resultsKey predictive factors identified include the fiscal year of attachment, age, rurality, and prior healthcare utilization. FPs who attached patients outside the CWLs did so more often in urban areas (+ 3% in metropolitan areas), and non-CWL-attached patients were slightly younger (− 3.4 years) and had generally lower healthcare needs compared with CWL-attached patients. Compared to those attached to a FP through a non-CWL approach, those attached through a CWL had a 4.7% lower incidence rate of ED visits in the year following attachment (IRR = 0.952; 95% CI: 0.946–0.960).

conclusionThese findings underscore the potential benefits of fostering greater participation in the CWLs among FPs and patients to promote equity in access to FPs.

Indexed as

Emergency Service, HospitalPhysicians, FamilyWaiting ListsAccess to Primary CareAdolescentAdultAgedEmergency Room VisitsFemaleHealth Services AccessibilityHumansMaleMiddle AgedPrimary Health CareQuebecRetrospective StudiesAdministrative health dataAttachmentCentralized waiting listEmergency departmentFamily physicianHealth inequitiesObservational studyPrimary healthcareRandom forestSociodemographic factors

Identifiers

PMID41519745
PMCPMC12882446

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LicenceCC BY-NC-ND
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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.