Experiences and preferences of people without access to primary care: Results from a national cross-sectional survey in Canada.

OBJECTIVE: To understand the health care-seeking behaviour and preferences of people in Canada who report not having a primary care clinician (PCC; family doctor or nurse practitioner). DESIGN: An anonymous, online, national cross-sectional survey was conducted. It was available from September 2022 to October 2022 in English and French. Responses were weighted based on sociodemographic factors to approximate the population of Canada. SETTING: Canada. PARTICIPANTS: People aged 18 years or older. MAIN OUTCOME MEASURES: Characteristics, health care-seeking behaviour, and preferences of people without a primary care clinician compared to people with one. RESULTS: A total of 9279 completed surveys were analyzed. About 21.8% of respondents said they did not have a primary care clinician. Among these, 83.1% said they were trying to find one and 66.2% of those looking reported doing so for over 1 year. Fewer men (vs women) (78.0% vs 89.3%; P<.001) and people without supplementary health benefits (vs with) (72.1% vs 85.8%; P<.001) reported looking. More people without a primary care clinician (vs with) indicated they tried getting care from a walk-in clinic (71.8% vs 41.2%; P<.001), but fewer reported their needs being met (40.6% vs 55.3%; P<.001). More people without a primary care clinician responded favourably to potential team- and neighbourhood-based care reforms. CONCLUSION: People without a regular family doctor or nurse practitioner face several challenges. Many are trying to find one, but cannot. They value relationship-based care yet are more likely to use walk-in clinics and less likely to be satisfied with that care compared to people with a primary care clinician. Reforms should align with the values and preferences of those without primary care.