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Where Canadians Go for Healthcare


5 June 2014

In 2011-12, only eighty-five percent of Canadians aged 12 and older had a regular doctor, leaving approximately four and a half million Canadians to seek regular medical care from other sources. Using data from the Canadian Community Health Survey (CCHS) for the years 2007-08 through 2011-12, we’ve examined where those without regular doctors typically go to seek medical care and advice, whilst comparing trends across time and across Canadian provinces and territories.

According to data from the 2011-12 cycle of the CCHS, 79.8% of Canadians without a regular doctor indicate having a place that they usually go when they are sick or require advice about their health, leaving only 20.2% – or 3.0% of the total population – without a usual place to seek healthcare. Across provinces and territories, there does exist variation in the proportion of those with a usual place where care is sought, but there are no pronounced regional trends.

Across Canada, walk-in clinics are by far the type of healthcare facility most used by those without a regular doctor, with 60.9% of respondents identifying walk-in clinics as the place they usually go for medical care. Emergency rooms rank second (13.5%), followed by community health centres (8.3%), appointment clinics (4.3%), doctors’ offices (3.3%), hospital outpatient clinics (2.3%), telephone health lines (0.9%), and other places (6.5%).

Looking at where Canadians typically go for medical care in the context of the entire population – not just among those without a regular doctor – the data reveals that 84.9% of Canadians have a regular doctor, 7.3% typically use walk-in clinics, 1.6% use emergency rooms, 1.0% use community health centres, 0.5% use appointment clinics, 0.4% use doctors’ offices, 0.3% use hospital outpatient clinics, 0.1% use telephones health lines, 0.8% use some other type of medical facility or provider, and 3.0% have neither a regular doctor nor another place they regular seek health care.

Walk-in clinics are the most common alternative to a regular doctor in nearly all provinces. They are the type of facility most commonly used in nine provinces, surpassed only by hospital outpatient clinics in Newfoundland & Labrador and community health centres in the territories. However, even among those provinces where walk-in clinics are most widely used, there is noticeable variation in the use of these types of facilities in comparison to others. For example, in New Brunswick, there exists less than a 8% gap between walk-in clinics and emergency room use, while in British Columbia there is a more than 73% gap between use of walk-in clinics and the next most common alternative, doctors’ offices.

In seven provinces, emergency rooms represent the second most common type of health care facility utilized by those without a regular doctor, while in Newfoundland & Labrador and the territories walk-in clinics rank second. In Saskatchewan and British Columbia, appointment clinics and doctors’ offices rank second, respectively.

Interestingly, use of walk-in clinics is most common among the more heavily populated provinces of Ontario, British Columbia, Alberta, and Manitoba, with Quebec – where use of community health centres is much higher than in other large provinces – being the only of Canada’s five most populous provinces wherein use of walk-in clinics does not exceed the national average. Use of emergency rooms is, however, highest among the four Atlantic provinces and Quebec, while use of hospital outpatient clinics is, again, highest among the Atlantic provinces as well as the territories. Use of appointment clinics is highest in New Brunswick and Saskatchewan, although residents of Newfoundland and Labrador, Nova Scotia, Manitoba, and the territories also utilize appointment clinics in proportions exceeding the national average. Use of doctors’ offices is highest in Saskatchewan, but also higher than the national average in Newfoundland and Labrador, Nova Scotia, Manitoba, Alberta, and British Columbia.

In all but three provinces and the territories, a majority of those without regular doctors but with a usual place where they seek care identify walk-in clinics as the kind of health care facility they would typically use. In the territories, over half of these people use community health centres, but in Nova Scotia, New Brunswick, and Newfoundland and Labrador the use of no single type of facility exceeds that of all others combined. Rather, within these three provinces there exists greater variation in the types of facilities used than among other provinces.

Interestingly, it is also in the Atlantic provinces where the biggest changes have occurred during the period for which data is available (2007-2012). In no other province has a shift of more than five percent in the use of a single type of facility occurred during this five year period, but in Newfoundland & Labrador, Prince Edward Island, and Nova Scotia, much more sizeable shifts have occurred. New Brunswick, is the only province within the Atlantic region that did not experience any significant shifts.

Specifically, in these three provinces, use of individual facility type shifted, on average, by 5.3%, while in all other provinces the average shift was equal to only 1.4%. In Newfoundland & Labrador, these shifts were primarily characterized by respective declines of 8.2% and 9.6% in the use of community health centres and appointment clinics, and respective increases of 11.2% and 7.6% in the use of walk-in clinics and hospital outpatient clinics. In Prince Edward Island, use of walk-in clinics increased by 22.9%, while use of hospital outpatient clinics declined by 17.7%. In Nova Scotia, the use of walk-in clinics increased by 15.5%, while use of community health centres and hospital outpatient clinics decreased by 6.4% and 7.1% respectively.

While approximately fifteen percent of Canadians do not have a regular doctor, only three percent are entirely without a place where they typically seek medical care. Among those who do have such a place, walk-in clinics are by far the single type of health care facility most commonly used. And, although the utilization of such clinics does vary substantially across provinces, between 2007 and 2012, their use has increased slightly across Canada and to a greater extent in those provinces where they were least used, accompanied by notable declines in the use of community health centres, appointment clinics and hospital outpatient clinics.

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Unless otherwise noted, all data contained herein is drawn from the Canadian Community Health Survey (CCHS) 2000/01-2011/12. The CCHS is a joint effort of Health Canada, the Public Health Agency of Canada, Statistics Canada, and the Canadian Institute for Health Information (CIHI).