1 in 7 ER visits in Canada are for conditions that could have been managed in primary care: report
Access to family doctors and other primary care providers is a crucial aspect of healthcare in Canada. However, new data suggests that many Canadians are facing challenges in accessing these essential services, leading them to seek care in emergency departments. According to the Canadian Institute for Health Information (CIHI), approximately one in seven visits to the emergency department could have been managed by a family doctor or another primary care provider. Furthermore, half of these visits could have been addressed virtually, highlighting the need for improved access to primary and virtual care services.
The report released by CIHI focuses on primary and virtual care access in relation to visits to emergency departments between April 2023 and March 2024. It builds upon previous findings that over five million Canadian adults do not have a family health provider, exacerbating the issue of limited access to timely care. To measure the difficulty in accessing care, CIHI developed a new indicator: emergency department visits for conditions that could have been managed in primary care settings.
Sunita Karmakar-Hore, CIHI’s manager of health system performance reporting, highlighted that individuals without access to a family doctor or walk-in clinic tend to have more visits to the emergency department for primary care conditions, especially during weekdays. Surprisingly, even those with access to a primary care provider still account for a significant percentage of emergency department visits for conditions that could have been managed elsewhere, even on weekends.
The impact is particularly notable among children aged two to nine, with 26% of their emergency department visits being potentially manageable in primary care settings. This underscores the challenges faced by parents in accessing timely care for their young children, especially when facing conditions like antibiotic prescriptions, colds, sore throats, ear infections, and prescription refills.
Dr. Fraser Mackay, an emergency physician and chair of the Canadian Association of Emergency Physicians, emphasized the interconnected challenges in emergency medicine and primary care. He noted that the scarcity of resources, including emergency and family physicians, as well as funding allocation issues, contributes to the strain on healthcare services.
While emergency departments are grappling with various pressures, Dr. Kyle Vojdani, chief and medical director of an emergency department in Toronto, stressed that patients seeking care in the emergency department typically require urgent medical attention. He acknowledged that while the lack of access to a family doctor may contribute to overcrowding, it is not the primary driver of pressure on emergency departments.
In rural and remote areas, where healthcare resources are limited, the disparities in access to primary care are further magnified. Rural communities experience a higher proportion of emergency visits for conditions that could be managed in primary care compared to urban areas. Karmakar-Hore highlighted the unique challenges faced by individuals in rural settings, where the emergency department may serve as their primary care facility.
Ultimately, the goal of the CIHI report and its indicators is to drive improvement efforts in enhancing access to primary and virtual care services. While acknowledging the importance of emergency departments as vital healthcare resources, the focus remains on addressing the root causes of limited access to primary care providers and implementing strategies to better meet the healthcare needs of all Canadians.
