Social and Health Determinants of Patient Satisfaction and Wait times for Primary Care in Canada
Abstract
The most common measures used by patients in which quality of care is judged would be satisfaction and wait times for care. Despite their relevance to gauging performance of health care services, they have not been widely studied in the context of primary care. A gap in the literature exists in studies assessing the relationship between patient satisfaction and wait times for primary care services in relation to social and health determinants. The objective of this thesis was to assess the association of individual level social and health determinants with patient satisfaction and wait times in primary care in adult Canadians. This dissertation is comprised of three studies; two systematic reviews and one cross sectional analysis of pooled data from the 2015/2016 and 2019 cycles of the Canadian Community Health Survey (CCHS). We found that the common determinants influencing both outcomes were health status, comorbidities, and socioeconomic status based on the 2 systematic reviews conducted. The cross-sectional analysis corroborated these findings, as those with worse self-reported health status (OR 0.62, 95% CI; 0.54-0.70) andthose with multiple chronic conditions (multimorbidity) (OR 0.81, 95% CI; 0.73-0.90) were found to have significantly lower odds of reporting satisfactory experiences. Those with excellent self-reported health status (OR 1.10, 95% CI;1.01- 1.19) and those classified as having a multimorbidity (OR 1.17, 95% CI; 1.03, 1.33) were also found to be at significantly higher odds of waiting 1 month or more for primary care. It is recommended that future studies investigate causal pathways between social and health determinants on patient satisfaction alongside wait times for care.