Grant: Travel Awards - Institute Community Support

A decade after their implementation, we investigate the impact of Quebec's Groupes de médicine de famille (GMFs) on access to primary care and perceived remaining barriers. We emphasize potential access - i.e. several measures that capture whether an individual reports having timely access to needed care. We use data from seven waves of the Canadian Community Health Survey to capture reported access to primary care and barriers to access. GMF participation is voluntary and they emerged at different rates in different health regions across Quebec. We constructed a GMF 'participation' measure using the share of primary care physicians participating in GMFs in each health region and year. Our primary measure of potential access is having a regular doctor. We verified that regions with ultimately high vs. low rates of GMF participation were not systematically different in the pre-policy period in terms socioeconomic characteristics or health care access, making comparisons of these regions appropriate. Preliminary results suggest that rates of having a regular doctor have increased over time in all Quebec health regions. However, this measure of access varies across regions and some, including Montreal, always report lower rates of access. Individual characteristics that predict access to primary care are age, sex, education, income, immigrant status, language spoken, number of chronic diseases and self-reported health. Controlling for time trends, fixed differences between regions, and individual characteristics, reported access does not change significantly as GMF participation increases. Improved access to primary health care was one of the primary objectives of Quebec's primary care reform a decade ago. Our findings suggest that increased GMF participation has not improved several important measures of access, and that additional measures may be necessary to increase potential access to primary care.