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Walk-in clinic patient characteristics and utilization patterns in Ontario, Canada: a cross-sectional study

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Background — Walk-in clinics are common in North America and are designed to provide acute episodic care without an appointment. We sought to describe a sample of walk-in clinic patients in Ontario, Canada, which is a setting with high levels of primary care attachment.

Methods — We performed a cross-sectional study using health administrative data from 2019. We compared the sociodemographic characteristics and healthcare utilization patterns of patients attending 1 of 72 walk-in clinics with those of the general Ontario population. We examined the subset of patients who were enrolled with a family physician and compared walk-in clinic visits to family physician visits.

Results — Our study found that 562 781 patients made 1 148 151 visits to the included walk-in clinics. Most (70%) patients who attended a walk-in clinic had an enrolling family physician. Walk-in clinic patients were younger (mean age 36 yr v. 41 yr, standardized mean difference [SMD] 0.24), yet had greater healthcare utilization (moderate and high use group 74% v. 65%, SMD 0.20) than the general Ontario population. Among enrolled Ontarians, walk-in patients had more comorbidities (moderate and high count 50% v. 45%, SMD 0.10), lived farther from their enrolling physician (median 8 km v. 6 km, SMD 0.21) and saw their enrolling physician less in the previous year (any visit 67% v. 80%, SMD 0.30). Walk-in encounters happened more often after hours (16% v. 9%, SMD 0.20) and on weekends (18% v. 5%, SMD 0.45). Walk-in clinics were more often within 3 km of patients’ homes than enrolling physicians’ offices (0 to < 3 km: 32% v. 22%, SMD 0.21).

Interpretation — Our findings suggest that proximity of walk-in clinics and after-hours access may be contributing to walk-in clinic use among patients enrolled with a family physician. These findings have implications for policy development to improve the integration of walk-in clinics and longitudinal primary care.

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Citation

Lapointe-Shaw L, Kiran T, Salahub C, Austin PC, Berthelot S, Desveaux L, Lofters A, Maclure M, Martin D, McBrien KA, McCracken RK, Rahman B, Schultz SE, Shuldiner J, Tadrous M, Bird C, Paterson JM, Bhatia RS, A Thakkar NA, Na Y, Ivers NM. CMAJ Open. 2023; 11(2):E345-56. Epub 2023 Apr 25.

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