PUPPY (unattached patients)
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
COVID-19 caused unprecedented disruption to primary care (PC) in Canada and globally. Many PC clinics closed, and patients were fearful and uncertain about how to access care.
Family physicians (FP), nurse practitioners (NP), and pharmacists (RPh), made major PC practice shifts. For example: new intake and distancing protocols, rapid virtual care implementation, reduced referral and diagnostics access, redeployment to COVID-19 triage and care centres, and in some cases, increased publicly funded RPh scope of practice. Studying the impact of these rapid PC changes on patient access is vital as PC accounts for the vast majority of healthcare visits; and PC that is timely and appropriate reduces tertiary care burden.
In times of pandemics, patients may turn to their PC provider to evaluate if they are infected, continue ongoing non-COVID care for other acute or chronic conditions, and receive reassurance and counselling for their mental health. Disruptions in PC access may culminate in delayed and unmet care, negatively affecting population health outcomes, patient experiences, provider wellbeing, and add burden to the healthcare system. Access challenges disproportionately impact vulnerable patients without prior attachment to a PC provider (i.e., unattached patients) and those with chronic conditions.
We can learn from evaluating these early rapid changes to determine best practices for future pandemics and to support better PC access generally. Understanding gaps in access and coordination of PC and planning for the road ahead is urgently needed.
Our expanded longitudinal mixed methods approach addresses the quadruple aim of enhancing patient experience, promoting care team wellbeing, improving population health, and optimizing costs; across the waves of COVID-19 and the fallout.
This study is led by Dalhousie University Family Medicine (Dr. Emily Gard Marshall, PI) and includes Ontario and Quebec investigators. See website for more details PUPPY Study
