Shifts in patient and physician trends shape primary care in Alberta

Background and goal: In this study, researchers examined changes over time in characteristics of adults cared for by family physicians from 2004 to 2020 in Alberta, Canada, along with trends in family physicians and their practice patterns for adults over 18 years old. 

Study approach: Using linked administrative health data, including physician billing claims and hospital/ambulatory data, the researchers created annual, population-based snapshots from 2004 to 2020 of adults seeing family physicians providing comprehensive care. They tracked patient mix (age, number of chronic conditions, mental health and substance-use conditions) and physician workload (number of clinic days providing primary care, patient contacts per clinic day, and unique adult patients cared for per year).

Main results

• The number of female physicians increased from 39% in 2004 to 46.7% in 2020, and graduates trained in low- and middle-income countries rose from 6.3% to 17.2%.

• The proportion of individuals aged 61-80 grew from 16.1% to 22.1%, and those with more than five chronic conditions nearly doubled.

• There were changes in physician practice over time including decreases in average days worked each year (167 in 2004, 156 in 2020), and the average number of adult visits per clinic day fell from 23 to 20.

Why it matters: These system level shifts help explain access pressures in primary care and offer a clear signal for health systems to use in workforce planning and resource allocation to meet rising patient complexity.