Association between patient attachment to a regular doctor and self-perceived unmet health care needs in Canada: A population-based analysis of the 2013 to 2014 Canadian community health surveys

Background: Although Canada operates a universal health care insurance system, equitable access to required health care services when needed still poses a challenge for some. The aim of this study was to examine the relationship between patient attachment to a family physician and self-perceived unmet health care needs (UHN) in Canada, after adjusting for predisposing, enabling, and need factors of the behavioral model of health services use. Methods: This cross-sectional study used data from the Canadian Community Health Surveys, cycle 2013 to 2014. A sample of 58 462 individuals aged 12 years and over was analyzed. Logistic regression models were used to examine the relationship between patient attachment and self-perceived UHN. Results: An estimated 10.41% of the Canadian population 12 years and older reported having UHN in the previous year. Among people with self-perceived UHN, there was significantly greater likelihood of unattachment to a family physician-no regular doctor or having a regular site of care, being younger, being female, being divorced, separated or widowed, having higher education, having lower income, having poorer perceived physical or mental health, having a weak sense of community belonging, having at least one chronic condition, and having greater activity limitations. Conclusion: Ongoing public discourses on improving primary health care performance and reducing the burden of UHN in Canada should prioritize efforts that promote and facilitate the use of a regular family physician.