{"id":23318,"date":"2026-02-04T09:38:06","date_gmt":"2026-02-04T14:38:06","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=23318"},"modified":"2026-02-24T09:43:07","modified_gmt":"2026-02-24T14:43:07","slug":"primary-care-unattachment-impact-on-mortality-hospitalizations-and-costs","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/primary-care-unattachment-impact-on-mortality-hospitalizations-and-costs\/","title":{"rendered":"Primary care unattachment: impact on mortality, hospitalizations and costs"},"content":{"rendered":"

Introduction<\/strong> \u2014 Primary care attachment is the formal or informal affiliation with a regular primary care clinician. In countries with near-universal primary care, a physician’s retirement typically results in the transition of care to another doctor. In many low- and middle-income countries, as well as the United States and Canada, this seamless transition often does not exist. A period of unattachment follows, during which the individual lacks primary care.<\/p>\n

Methods<\/strong> \u2014 This population-based retrospective cohort study of 12 726 325 Ontarians uses health administrative data to examine how the duration of attachment and unattachment influences mortality, healthcare costs, and hospitalizations.<\/p>\n

Results<\/strong> \u2014 A period of increased vulnerability was observed within the first 5 years of unattachment, associated with 85% higher odds of all-cause mortality compared with those attached for 15+ years. This association was amplified among multimorbid patients. Relative to long-term attached individuals without comorbidity, multimorbid patients exhibited approximately 5-fold higher all-cause mortality when stably attached, increasing to roughly 12-fold among those recently unattached. Cost and hospitalization outcomes exhibited similar patterns.<\/p>\n

Conclusion<\/strong> \u2014 These findings carry crucial policy implications, underscoring the need for strategies that promote stable attachment, particularly for individuals with multimorbidity, and better patient support following the loss of a primary care physician.<\/p>\n","protected":false},"excerpt":{"rendered":"

Introduction \u2014 Primary care attachment is the formal or informal affiliation with a regular primary care clinician. In countries with near-universal primary care, a physician’s retirement typically results in the transition of care to another doctor. In many low- and middle-income countries, as well as the United States and Canada, this seamless transition often does […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[61,60,28],"migration-helper-qa-sample-set":[],"class_list":["post-23318","journal_article","type-journal_article","status-publish","hentry","topic-health-economics","topic-policy-and-program-evaluation","topic-primary-care"],"acf":{"citation":"Fitzsimon J, St-Amant A, Green ME, Glazier RH, Gayowsky A, Premji K, Frymire E, Bjerre LM. Health Aff Sch<\/em>. 2026; 4(2): qxag030.","source_url":"https:\/\/doi.org\/10.1093\/haschl\/qxag030","ices_scientist":[1248,1250,1163],"site":[6737],"research_program":[6745,6747],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":[23579],"video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\nICES | Primary care unattachment: impact on mortality, hospitalizations and costs<\/title>\n<meta name=\"description\" content=\"Introduction \u2014 Primary care attachment is the formal or informal affiliation with a regular primary care clinician. 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