Trends in access to primary care among Canadian older adults before, during, and following the COVID-19 public health emergency

Abstract

The COVID-19 pandemic significantly disrupted access to primary care, particularly for older adults with complex health needs. We conducted a cross-sectional survey to study changes in behaviours of access to primary care among Canadian older adults and how having an attached family physician (FP) impacts their experiences. People aged 65 and older living in Canada with at least one contact with the primary care since 2015 reported on their healthcare experiences across three periods: pre-, during and post-COVID-19 public health emergency. Findings from 1,899 participants revealed that while some aspects of access improved after the COVID-19, many challenges persisted. The proportion of older adults with an attached FP dropped from 87% before COVID-19 (2019) to 79% during the post period (2022–2024). Long wait times, delayed referrals, and a lack of available services remained. As a result, emotional well-being, physical activity, economic and quality of life were significantly impacted, with many respondents reported ongoing effects. Older adults with poorer health status and in rural areas are among those who experienced the greatest hardship; whilst people with a regular FP reported to have less difficulties when access to care and experienced better health outcomes.