Changing primary care capacity in Canada: protocol for a cross-provincial mixed methods study.

Area of Science:

• Health Services Research
• Primary Care Policy
• Health Workforce Planning

Background:

• Canada experiences a growing gap between primary care needs and system capacity, influenced by an aging population and increasing complexity.
• Factors such as declining practice volumes, administrative burdens, and evolving clinician roles impact primary care capacity.
• Existing workforce planning tools inadequately address these dynamic factors, potentially worsening access and health inequities.

Purpose of the Study:

• To identify and explore factors influencing population primary care service use and system capacity over time.
• To develop and validate planning tools for estimating future primary care needs and capacity.
• To support equitable primary care capacity planning for a growing and aging Canadian population.

Main Methods:

• Qualitative interviews with family physicians (FPs) and nurse practitioners (NPs) to understand workload determinants.
• Analysis of administrative health data from 2004/2005 to 2023/2024 to assess primary care need and capacity factors.
• Development of analytical models projecting future needs and capacity under various stakeholder-informed scenarios across four Canadian provinces.

Main Results:

• Identified key patient, practice, and system-level factors shaping primary care workload and service delivery.
• Quantified trends in primary care need (demographics, complexity, intensity) and capacity (provider supply, roles, volumes) over two decades.
• Developed and validated projection models for future primary care needs and capacity.

Conclusions:

• The developed planning tools offer a novel approach to primary care workforce and capacity planning.
• Findings will inform evidence-based strategies to improve patient access and reduce clinician overwork.
• This research supports equitable distribution of primary care resources to meet evolving population health demands.