Primary health care provider availability and accessibility: a comparison of responses from providers and their office staff, results from the Models and Access Atlas of Primary Care – Nova Scotia (MAAP-NS) population study

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BACKGROUND: Primary care providers’ (i.e., physicians and nurse practitioners) perceptions of their availability and accessibility may differ from those of their staff (i.e., clerical or reception staff), who are the gatekeepers to accessing care. The objective of this study is to compare responses of primary care providers and their staff on questions reflecting provider availability and accessibility. METHODS: We conducted a population survey within Nova Scotia Canada that included 369 primary health care providers and their staff. Main outcomes measured included whether primary health care providers were accepting new patients, requiring meet-and-greets before accepting new patients, had a one-issue-per-visit policy, and had weekly office-hours. RESULTS: Among providers, 87% reported accepting new patients whereas only 64% of their staff said that they do (p < 0.001). Rates of unconditionally accepting patients (11% of providers and 10% of staff) did not differ (p = 0.62). Acceptance of opioid-requiring patients was reported by 61% of providers and by 70% of their staff (p = 0.05). Requiring meet-and-greets was reported by 36% of providers and 52% of their staff (p < 0.001). There was no difference on a one-issue-per-visit policy (15% of providers and 16% of staff; p = 0.75). The median (IQR) number of hours per week spent working as an office-based primary care provider was 40 (30, 45) reported by the providers and 28.9 (21, 35) reported by staff (p < 0.001). CONCLUSIONS: Discrepancies between providers and staff when describing the same practices suggests that components of availability and accessibility are not uniformly understood. Staff who deal with members of the public seeking a provider may inaccurately indicate a provider’s acceptance of new patients, identifying a need for improved specific communication between providers and their staff.

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