학술논문
Walk-in clinic patient characteristics and utilization patterns in Ontario, Canada: a cross-sectional study.
Document Type
Academic Journal
Author
Lapointe-Shaw L; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont. lauren.lapointe.shaw@mail.utoronto.ca.; Kiran T; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Salahub C; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Austin PC; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Berthelot S; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Desveaux L; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Lofters A; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Maclure M; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Martin D; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; McBrien KA; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; McCracken RK; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Rahman B; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Schultz SE; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Shuldiner J; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Tadrous M; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Bird C; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Paterson JM; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Bhatia RS; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Thakkar NA; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Na Y; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.; Ivers NM; ICES (Lapointe-Shaw, Kiran, Austin, Schultz, Tadrous, Paterson, Bhatia, Na, Ivers), Toronto, Ont.; Institute of Health Policy, Management and Evaluation (Lapointe-Shaw, Kiran, Austin, Desveaux, Martin, Paterson, Bhatia, Ivers), University of Toronto, Toronto, Ont.; Division of General Internal Medicine and Geriatrics (Lapointe-Shaw), University Health Network and Sinai Health System, Toronto, Ont.; Department of Medicine (Lapointe-Shaw, Bhatia), University of Toronto, Toronto, Ont.; Women's College Institute for Health System Solutions and Virtual Care (Lapointe-Shaw, Martin, Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Toronto General Hospital Research Institute, University Health Network (Lapointe-Shaw, Salahub), Toronto, Ont.; Peter Munk Cardiac Centre, University Health Network (Bhatia), Toronto, Ont.; Department of Family and Community Medicine (Kiran) and MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Toronto, Ont.; Département de médecine familiale et de médecine d'urgence (Berthelot), Université Laval, Quebec City, Qué.; Institute for Better Health, Trillium Health Partners (Desveaux), Mississauga, Ont.; Department of Family and Community Medicine (Lofters, Martin, Ivers, Kiran), University of Toronto, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Department of Anesthesiology, Pharmacology and Therapeutics (Maclure), University of British Columbia, Vancouver, BC; Department of Family Medicine (Martin, Ivers), Women's College Hospital, Toronto, Ont.; Temerty Faculty of Medicine (Martin), University of Toronto, Toronto, Ont.; Departments of Family Medicine and Community Health Sciences (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Family Practice (McCracken), University of British Columbia, Vancouver, BC; Department of Family Medicine (McCracken), Providence Health Care, Vancouver, BC; Primary Health Care Branch (Rahman), Ministry of Health, Toronto, Ont.; patient partner (Bird), Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; College of Nurses of Ontario (Thakkar), Toronto, Ont.; Women's College Hospital Research Institute (Na), Women's College Hospital, Toronto, Ont.
Source
Publisher: Canadian Medical Association Country of Publication: Canada NLM ID: 101620603 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 2291-0026 (Electronic) Linking ISSN: 22910026 NLM ISO Abbreviation: CMAJ Open Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Walk-in clinics are common in North America and are designed to provide acute episodic care without an appointment. We sought to describe a sample of walk-in clinic patients in Ontario, Canada, which is a setting with high levels of primary care attachment.
Methods: We performed a cross-sectional study using health administrative data from 2019. We compared the sociodemographic characteristics and health care utilization patterns of patients attending 1 of 72 walk-in clinics with those of the general Ontario population. We examined the subset of patients who were enrolled with a family physician and compared walk-in clinic visits to family physician visits.
Results: Our study found that 562 781 patients made 1 148 151 visits to the included walk-in clinics. Most (70%) patients who attended a walk-in clinic had an enrolling family physician. Walk-in clinic patients were younger (mean age 36 yr v. 41 yr, standardized mean difference [SMD] 0.24), yet had greater health care utilization (moderate and high use group 74% v. 65%, SMD 0.20) than the general Ontario population. Among enrolled Ontarians, walk-in patients had more comorbidities (moderate and high count 50% v. 45%, SMD 0.10), lived farther from their enrolling physician (median 8 km v. 6 km, SMD 0.21) and saw their enrolling physician less in the previous year (any visit 67% v. 80%, SMD 0.30). Walk-in encounters happened more often after hours (16% v. 9%, SMD 0.20) and on weekends (18% v. 5%, SMD 0.45). Walk-in clinics were more often within 3 km of patients' homes than enrolling physicians' offices (0 to < 3 km: 32% v. 22%, SMD 0.21).
Interpretation: Our findings suggest that proximity of walk-in clinics and after-hours access may be contributing to walk-in clinic use among patients enrolled with a family physician. These findings have implications for policy development to improve the integration of walk-in clinics and longitudinal primary care.
Competing Interests: Competing interests: Lauren Lapointe-Shaw is supported by the University of Toronto Department of Medicine, the Toronto General Hospital Research Institute, the Women’s College Institute for Health System Solutions and Virtual Care and the Peter Gilgan Centre for Women’s Cancers at the Women’s College Hospital, in partnership with the Canadian Cancer Society. Tara Kiran is the Fidani Chair of Improvement and Innovation at the University of Toronto and is supported as a clinician scientist by the Department of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto. Noah M. Ivers is supported by a Canada Research Chair in Implementation of Evidence-based Practice and a clinician scholar award from the Department of Family and Community Medicine at the Women’s College Hospital and the University of Toronto.
(© 2023 CMA Impact Inc. or its licensors.)
Methods: We performed a cross-sectional study using health administrative data from 2019. We compared the sociodemographic characteristics and health care utilization patterns of patients attending 1 of 72 walk-in clinics with those of the general Ontario population. We examined the subset of patients who were enrolled with a family physician and compared walk-in clinic visits to family physician visits.
Results: Our study found that 562 781 patients made 1 148 151 visits to the included walk-in clinics. Most (70%) patients who attended a walk-in clinic had an enrolling family physician. Walk-in clinic patients were younger (mean age 36 yr v. 41 yr, standardized mean difference [SMD] 0.24), yet had greater health care utilization (moderate and high use group 74% v. 65%, SMD 0.20) than the general Ontario population. Among enrolled Ontarians, walk-in patients had more comorbidities (moderate and high count 50% v. 45%, SMD 0.10), lived farther from their enrolling physician (median 8 km v. 6 km, SMD 0.21) and saw their enrolling physician less in the previous year (any visit 67% v. 80%, SMD 0.30). Walk-in encounters happened more often after hours (16% v. 9%, SMD 0.20) and on weekends (18% v. 5%, SMD 0.45). Walk-in clinics were more often within 3 km of patients' homes than enrolling physicians' offices (0 to < 3 km: 32% v. 22%, SMD 0.21).
Interpretation: Our findings suggest that proximity of walk-in clinics and after-hours access may be contributing to walk-in clinic use among patients enrolled with a family physician. These findings have implications for policy development to improve the integration of walk-in clinics and longitudinal primary care.
Competing Interests: Competing interests: Lauren Lapointe-Shaw is supported by the University of Toronto Department of Medicine, the Toronto General Hospital Research Institute, the Women’s College Institute for Health System Solutions and Virtual Care and the Peter Gilgan Centre for Women’s Cancers at the Women’s College Hospital, in partnership with the Canadian Cancer Society. Tara Kiran is the Fidani Chair of Improvement and Innovation at the University of Toronto and is supported as a clinician scientist by the Department of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto. Noah M. Ivers is supported by a Canada Research Chair in Implementation of Evidence-based Practice and a clinician scholar award from the Department of Family and Community Medicine at the Women’s College Hospital and the University of Toronto.
(© 2023 CMA Impact Inc. or its licensors.)