Healthcare accessibility

Residents’ needs don’t match available services

The results of a healthcare survey conducted in Prince Edward County recently were shared at the Community and Economic Development Committee meeting earlier this month. It perhaps doesn’t come as a surprise that the biggest area of dissatisfaction was with those people who didn’t have a family doctor or couldn’t access one. Just 58 per cent of survey responders said they were registered with a family doctor. “We had quite a few that said they were registered with a family doctor now, but said they are going to need a new family doctor because they have moved or their doctor is leaving,” said Kim Koster, Programs Advisor with the municipality who presented the findings. Also significant, 48 per cent of respondents said they were dissatisfied when it came to access to health care. Just 11 per cent said they were very satisfied, although Koster noted the survey was just a snapshot in time.

The online survey (paper copies were also available at libraries) was open to all County residents and was undertaken in part as a result of budget meetings last December when Council provided recommendations regarding family physician recruitment. While the survey was geared to Prince Edward County, a similar survey was also undertaken in rural Hastings (excluding Belleville and Quinte West), something that was done to help the Ontario health team bring some regional context to the County picture. The presentation focused on the Prince Edward County survey only, which garnered good participation with almost 1,600 responses, one of the highest survey participations ever conducted. The rural Hastings survey received 800 responses, where Koster noted the responses received were very similar to the County survey.

Koster said one of the big drivers of satisfaction was from those participants who had lived in the County the longest. The number of people who answered the survey who had lived in the County for less than three years was about 15 per cent, so about 200 respondents. Those who had lived in the County the longest, i.e. more than 11 years were the most satisfied, with those living here 10 years or less being the most dissatisfied, and worse still were those living here less than three years.

Participants were asked if there were any services they had been unable to access in the last three years. Fifty-seven per cent of respondents who had lived here less than three years indicated they had not been able to access a doctor at all. For those who had lived here three years-plus, it was only 17 per cent. There were various reasons cited, such as not having a doctor, but also some found it too hard to get an appointment with their doctor, together with complaints about the healthcare waiting list. “Vision as well, nurse practitioner, dentist, mental health and foot care were also what people talked about what they couldn’t access at all.”

Most survey respondents were in the 55 to 75 age group. “You probably have people more engaged in health care issues in this age group,” said Koster. She noted some under-represented groups in the survey. “We had very few respondents in a youth category under 24, 18 to 24, and under 18.” Koster said Ontario data suggests that 25 per cent of Ontarians have some kind of disability; the survey showed about 10 per cent. By ward, Picton and Wellington were considered over-represented. In terms of demographics, more women than men responded. “You can hypothesise women are sometimes the gatekeeper of these services in the family and we definitely saw that people were encouraged in the questions and they certainly did answer on behalf of their families, so we were capturing more than just those women.”

“In terms of the providers survey respondents have used, a high percentage had seen a family doctor, a dentist, a lot going to emergency,” explained Koster. “I think we know that in the County, we have people using emergency as a walk-in clinic in the absence of a walk-in clinic, as opposed to all those people necessarily going for an emergency.” Forty per cent related to not having a family doctor, or losing one, or having to go too far for one. It was also noted some had difficulty in getting a doctor’s appointment, the length of the wait list or issues with the Health Care Connect policy. “It was noted some disliked virtual appointments, and some wished the County had a walk-in clinic.”

They did have a few positive comments about people expressing gratitude about the health care they have received and they were satisfied with wait times and the emergency treatment they have received, and the value of nurse practitioners to take pressure off family doctors for primary care. “We asked people not only what providers they used, but which ones they left the County to use.” Seventy-two per cent said they had used a family doctor, with 16 per cent saying they had left the County to use a family doctor. “Seventy percent of respondents said they used a dentist, 18 per cent said they left the County to use a dentist.” The highest number of people leaving the County for health care needs was for vision care at 27 per cent, followed by family doctor and dentist.

About half the people that were travelling to access health care said they would prefer to stay in the County. Notable was 74 per cent of respondents said travelling outside the County was not a barrier. “This is how people are feeling now based on the last three years, but there are also emerging issues in some of the qualitative comments when we asked how satisfied are you with your ability to travel to appointments,” explained Koster. “They would say, ‘I am satisfied now, but I am concerned about future’, so there are things to take from the comments.”

The survey also asked some questions about homecare and virtual homecare where Koster noted that most respondents, 84 per cent, said they had not used any homecare. For those who had, they were asked how easy or difficult it was to access. “Some people saying they were really happy with e-nurses, the PSWs that came to see them, but it was trying to get them to come, if somebody was sick they couldn’t be replaced.” The survey showed it was hard to get appointments, but the people who came to see them, when they did, they were happy with. “Some people commented about having to hire privately and even finding that difficult when they were offering a higher wage to try and attract someone.”

The April 11 Community and Economic Development Committee meeting is available for viewing on the County’s YouTube channel (bit/.ly/LiveStreamPEC) with survey results available as part of the agenda package found on the County’s website.