4C
Changing primary care capacity in Canada: A cross-provincial mixed methods study to inform workforce planning
Funded by:
Summary
There are more family doctors and nurse practitioners per person than ever before in Canada, but primary care access is falling, inequities are widening, and clinicians report stress and overwork. Several factors may explain the gap between primary care need and system capacity. Population aging, increasing clinical complexity, and increasing service intensity may shape primary care needs. Falling practice volumes, increasing administrative workload, changing clinician demographics, and new health system roles (e.g. hospitalist and focused practices) may shape system capacity. Existing workforce planning tools consider population demographics, but not these other potentially important factors.
This mixed-method, multi-province (British Columbia, Manitoba, New Brunswick, and Nova Scotia) project explores how primary care workload, factors shaping population service use, and factors shaping system capacity are changing over time, and use this information to develop planning tools to estimate future need and capacity.
Objectives
Objectives and associated research questions are to:
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1. Understand, from the perspective of primary care clinicians, the factors shaping workload over time:
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RQ 1.1 What factors do family physicians (FPs) and nurse practitioners (NPs) perceive as being important in shaping their workload in primary care and do they perceive that their workload has changed over time?
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RQ 1.2 How do perceptions of factors shaping workload vary by gender and other clinician characteristics?
2. Quantify factors shaping primary care need and system capacity over time (2004/5 to 2023/4):
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RQ 2.1 How have population aging, complexity, and service intensity contributed to changes in primary care service use?
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RQ 2.2 How might primary care service use change if inequities in access are addressed?
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RQ 2.3 How are elements of administrative workload (including testing, imaging, prescriptions, referrals) shaping capacity for direct patient care?
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RQ 2.4 To what extent are changing practice patterns, clinician demographics, and roles of FPs and NPs outside community-based primary care shaping system capacity?
3. Develop models to estimate and compare future primary care need and capacity under a range of policy-relevant scenarios.
Information is urgently needed to support primary care capacity planning in order to equitably meet the needs of a growing and aging population. Findings can also inform changes to the organization, deployment, and support of primary care providers that can ensure health human resources are optimized to meet population needs.
Team Members
Nominated Principal Investigator: Ruth Lavergne
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Co-Principal Investigators: Agnes Grudniewicz, Lindsay Hedden, David Rudoler, Antoine Saure, Julie Esley, Ted McDonald.
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Co-Investigators & Collaborators: Ruth Martin-Misener, Helena Piccinini-Vallis, Hugh Shiplett, Caroline Jose, Claire Johnson, Jennifer Hakim, Jonathan Patrick, Alan Katz, Ian Scott, Rita McCracken, Erin Wilson, Elizabeth Nethery, Rick Glazier, Sarah Simkin, Elaine Moody, Fiona Bergin, Adrien MacKenzie, Rebecca Correira, François Gallant, Emilie Dufour.