Evidence for innovations that improve equity in access to primary care: Cross-jurisdictional comparative analysis of longitudinal national survey data, policy review and synthesis

Primary care - access to doctors, nurses and other health care providers for general health concerns - forms the backbone of health care systems. Ideally access to primary care should be equitable - this means all people with similar needs for primary care should get similar access, regardless of their social or economic position. Over the past 20 years, provinces and territories have made different policy choices with the goal of improving Canadians' access to primary care. Some research suggests that people experiencing social or economic marginalization may have been less likely to benefit from policy changes. There is data showing that equity in access to primary care has gotten worse in some provinces, but we don't have information about the whole country. Differences across provinces and territories in whether resources are aligned with peoples' needs and whether equity is considered in tracking health system goals may help explain where we have and have not seen changes in equity. This project will: 1) Use national data from the Canadian Community Health Survey to describe how equity in access to primary care has changed between 2001/2002 and 2019/2020 within all provinces and territories. 2) Review and summarize the policy choices made across provinces, with a focus on characteristics of policies that might shape equity in access to care. 3) Bring together information from Objectives 1 and 2 to identify the characteristics of policy changes that are most promising for improving equity in access to primary care. Strong primary care is very important for health systems that are able to deliver good outcomes, value for money, and positive experiences for patients and clinicians. This project will provide information about the characteristics of innovations in primary care delivery most likely to support equity in addition to these goals.