Photo Credit: Freepick

The following is a summary of “Assessing the impact of attachment to primary care and unattachment duration on healthcare utilization and cost in Ontario, Canada: a population-based retrospective cohort study using health administrative data,” published in the March 2025 issue of BMC Primary Care by Fitzsimon et al. 

Insufficient access to primary care is a major public health issue in Ontario, Canada, particularly for unattached residents. 

Researchers conducted a retrospective study to assess healthcare utilization and costs among unattached individuals in Ontario. 

They conducted a population-based retrospective cohort study using health administrative data, comparing provincially insured residents with consistent attachment status (April 1, 2021, to March 31, 2022) to those who were unattached. Multivariable regression analyses were used to examine associations between attachment status, duration of unattachment, demographic and health characteristics, and healthcare utilization and costs. 

The results showed that prolonged unattachment to primary care was linked to increased healthcare costs, particularly in individuals with higher comorbidity burdens. Attached residents with low comorbidities had a median cost of $287, rising to $3,711 for those with high comorbidities (cost ratio: 12.93, CI: 12.86–13.01, p < 0.0001). Unattached individuals with low comorbidities had a median cost of $238 (cost ratio: 0.83, CI: 0.82–0.83, P < 0.0001), increasing to $7,106 for high comorbidities (cost ratio: 24.76, CI: 24.27–25.26, P < 0.0001), and $8,177 for long-term unattached with high comorbidities (cost ratio: 28.49, CI: 26.61–30.49, P < 0.0001). 

Investigators highlighted the significant impact of long-term unattachment on patients and the healthcare system, with chronic disease exacerbating these effects. These results were crucial for shaping programs and policies to reduce emergency department visits, hospitalizations, and healthcare costs. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02771-8