PUPPY Study – Problems Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID‑19 Pandemic Year: A Longitudinal Mixed Methods Study with Rapid Reporting and Planning for the Road Ahead

Marshall, Emily G | $407,552

Nova Scotia Dalhousie University 2020 CIHR Operating Grant

The majority of health care visits are to primary care providers such as family physicians, nurse practitioners, and pharmacists. These individuals make up the core care team for most people. They normally help coordinate and manage health care. COVID‑19 has caused significant changes in primary care. In Canada, many walk-in clinics and family practices have closed. Pharmacies remain open but with restrictions on patient interactions. Other major changes in care (e.g., virtual care, reduced referrals) have been made to respect public health and emergency orders. During these times with significant restrictions, patients can be unclear or unaware of how to get the right care, at the right time, from the right provider. Patients also fear getting COVID‑19 and avoid care settings. Some will also avoid seeking care for COVID-like symptoms due to fear and a lack of access to a primary care provider. Understanding the rapid changes in primary care and how to navigate these is challenging for everyone, but more so for people without a regular primary care provider to help guide them. This is especially true for vulnerable groups (e.g., those with serious mental illness) and those with chronic health conditions that require ongoing, frequent care (e.g., bloodwork, scans, medication changes). COVID-19-related disruptions may lead to significant delays in treatments or unmet health care needs for many people. This may negatively affect population health outcomes and increase costs to health and social systems. The proposed study builds on existing research with an experienced team. The team will work to understand critical gaps in primary care access and coordination by comparing data from before, during, and after the pandemic. Multiple sources of data will be used such as policy makers, primary care providers, patients, waitlist data, healthcare billings, and prescribing data. The results are critical for strengthening primary care during and beyond the COVID‑19 pandemic.

With funding from the Government of Canada

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