Grant: Travel Awards - Institute Community Support

Family Medicine Groups (FMGs) are a new PC model created in Québec 10 years ago. We wanted to evaluate whether FMGs have improved primary care (PC) for adolescents by improving accessibility of PC and decreasing inequities in care between adolescents of low and high socioeconomic status (SES). We conducted a study using 2010-2013 health utilization data for adolescents aged 12-18. We used statistical regression models to test relationships between 4 PC types (FMGs, family physicians not part of FMGs, pediatricians, or no PC) and 2 outcomes: emergency department (ED) visits (indirectly measures PC accessibility; higher ED use indicates lower PC accessibility) and PC visits. In the model, we accounted for differences in age, sex, health status, geographic location, and SES among the patients. We also examined the reasons for ED visits. Finally, we conducted tests to see if FMGs reduced inequities in care between adolescents of poor and wealthy backgrounds. In our study, 56.5% of adolescents had no PC, 19.7% were in FMGs, 10.1% were in non-FMGs, and 13.7% were in pediatric care. Adolescents receiving care from non-FMGs or pediatricians, or had no PC, used the ED less than adolescents in FMGs. Similarly, adolescents receiving PC from non-FMGs or pediatricians received more PC visits than adolescents receiving PC from FMGs. FMGs did not seem to reduce inequities either. For all 4 PC types, wealthier adolescents received more PC visits, and used the ED less, compared to less wealthy adolescents. Adolescents mostly went to the ED for issues related to trauma or gastrointestinal complaints. Overall, FMGs did not increase access or reduce inequities in PC for adolescents. Moving forward, health policies must put more emphasis on improving PC for adolescents.