title: Access to primary care and other health care use among western Canadians with chronic conditions: a population-based survey.
abstract: BACKGROUND
  For adults with chronic conditions, access to primary care, including multidisciplinary care, is associated with better outcomes. Few studies have assessed barriers to such care. We sought to describe barriers to primary care, including care from allied health professionals, for adults with chronic conditions.
  
  
  METHODS
  We surveyed western Canadians aged 40 years or older who had hypertension, diabetes, heart disease or stroke about access to primary care and other use of health care. Using log binomial regression, we determined the association between sociodemographic variables and several indicators of access to primary care and care from allied health professionals.
  
  
  RESULTS
  Of the 2316 people who were approached, 1849 (79.8%) completed the survey. Most of the respondents (95.1%) had a regular medical doctor, but two-thirds (68.1%) did not have after-hours access. Only 6.1% indicated that allied health professionals were involved in their care, although most respondents (87.3%) indicated they would be willing to see a nurse practitioner if their primary care physician was not available. Respondents who were obese or less than 65 years of age were less likely to have a regular medical doctor. Individuals who had diabetes, lived in a rural area, were residents of Alberta or had poorer health were more likely to have allied health professionals involved in their care.
  
  
  CONCLUSIONS
  The survey results identified barriers to accessing primary care for people with chronic conditions. Opportunities for improving access to primary care may include greater involvement by allied health professionals, such as nurse practitioners.
authors: Department of Medicine, University of Calgary, Calgary, Alta.
authors: Robert G
authors: RG
authors: Weaver
authors: Department of Medicine, University of Calgary, Calgary, Alta. ; Department of Community Health Sciences, University of Calgary, Calgary, Alta.
authors: Braden J
authors: BJ
authors: Manns
authors: Department of Medicine, University of Alberta, Edmonton, Alta.
authors: Marcello
authors: M
authors: Tonelli
authors: Department of Community Health Sciences, University of Calgary, Calgary, Alta. ; Statistics Canada, Ottawa, Ont.
authors: Claudia
authors: C
authors: Sanmartin
authors: Department of Medicine, University of Calgary, Calgary, Alta. ; Department of Community Health Sciences, University of Calgary, Calgary, Alta.
authors: David J T
authors: DJ
authors: Campbell
authors: Ottawa Hospital Research Institute, Ottawa, Ont.
authors: Paul E
authors: PE
authors: Ronksley
authors: Department of Medicine, University of Alberta, Edmonton, Alta.
authors: Richard
authors: R
authors: Lewanczuk
authors: Department of Family Medicine, Alberta Health Services, Calgary, Alta.
authors: Ted C
authors: TC
authors: Braun
authors: Statistics Canada, Ottawa, Ont. ; Ottawa Hospital Research Institute, Ottawa, Ont.
authors: Deirdre
authors: D
authors: Hennessy
authors: Department of Medicine, University of Calgary, Calgary, Alta. ; Department of Community Health Sciences, University of Calgary, Calgary, Alta.
authors: Brenda R
authors: BR
authors: Hemmelgarn