Access to Primary Care and Internet Searches for Walk-In Clinics and Emergency Departments in Canada: Observational Study Using Google Trends and Population Health Survey Data.

Ruth Lavergne,Joseph Ssendikaddiwa

doi:10.2196/13130

Abstract

BackgroundAccess to primary care is a challenge for many Canadians. Models of primary care vary widely among provinces, including arrangements for same-day and after-hours access. Use of walk-in clinics and emergency departments (EDs) may also vary, but data sources that allow comparison are limited.ObjectiveWe used Google Trends to examine the relative frequency of searches for walk-in clinics and EDs across provinces and over time in Canada. We correlated provincial relative search frequencies from Google Trends with survey responses about primary care access from the Commonwealth Fund’s 2016 International Health Policy Survey of Adults in 11 Countries and the 2016 Canadian Community Health Survey.MethodsWe developed search strategies to capture the range of terms used for walk-in clinics (eg, urgent care clinic and after-hours clinic) and EDs (eg, emergency room) across Canadian provinces. We used Google Trends to determine the frequencies of these terms relative to total search volume within each province from January 2011 to December 2018. We calculated correlation coefficients and 95% CIs between provincial Google Trends relative search frequencies and survey responses.ResultsRelative search frequency of walk-in clinic searches increased steadily, doubling in most provinces between 2011 and 2018. Relative frequency of walk-in clinic searches was highest in the western provinces of British Columbia, Alberta, Saskatchewan, and Manitoba. At the provincial level, higher walk-in clinic relative search frequency was strongly positively correlated with the percentage of survey respondents who reported being able to get same- or next-day appointments to see a doctor or a nurse and inversely correlated with the percentage of respondents who reported going to ED for a condition that they thought could have been treated by providers at usual place of care. Relative search frequency for walk-in clinics was also inversely correlated with the percentage of respondents who reported having a regular medical provider. ED relative search frequencies were more stable over time, and we did not observe statistically significant correlation with survey data.ConclusionsHigher relative search frequency for walk-in clinics was positively correlated with the ability to get a same- or next-day appointment and inversely correlated with ED use for conditions treatable in the patient’s regular place of care and also with having a regular medical provider. Findings suggest that patient use of Web-based tools to search for more convenient or accessible care through walk-in clinics is increasing over time. Further research is needed to validate Google Trends data with administrative information on service use.

Highlights

According to the Commonwealth International Health Policy Survey for adults in 11 countries, Canada ranks below average on timely access to care with only 43% of Canadians reporting to have gotten a same- or next-day appointment at their regular place of care and only 34% reporting to have access to after-hours care without going to the emergency room [4]
Over the study period from 2011 to 2018, walk-in clinic searches were most frequent in the western provinces of British Columbia, Alberta, Saskatchewan, and Manitoba
The percentage of respondents reporting that they were able to get a same- or next-day appointment tended to be higher in the western provinces (Table 2)

Summary

Introduction

According to the Commonwealth International Health Policy Survey for adults in 11 countries, Canada ranks below average on timely access to care with only 43% of Canadians reporting to have gotten a same- or next-day appointment at their regular place of care and only 34% reporting to have access to after-hours care without going to the emergency room [4]. We correlated provincial relative search frequencies from Google Trends with survey responses about primary care access from the Commonwealth Fund’s 2016 International Health Policy Survey of Adults in 11 Countries and the 2016 Canadian Community Health Survey. Conclusions: Higher relative search frequency for walk-in clinics was positively correlated with the ability to get a same- or next-day appointment and inversely correlated with ED use for conditions treatable in the patient’s regular place of care and with having a regular medical provider. Further research is needed to validate Google Trends data with administrative information on service use

Objectives

Methods

Results