Fiona Kouyoumdjian, Marie Kim, Tara Kiran, Stephanie Cheng, Kinwah Fung, Aaron Orkin, Claire E. Kendall, Samantha Green, Flora I. Matheson and Lori Kiefer. 2019. Attachment to primary care and team-based primary care. Canadian Family Physician 65 (10): e433-3422.
To examine attachment to primary care and team-based primary care in the community for people who experienced imprisonment in Ontario, and to compare these attachment data with data for the general population. Design Population-based retrospective cohort study.
All persons released from provincial prison in Ontario to the community in 2010 who were linked with provincial health administrative data, and an age- and sex-matched general population group.
Main outcome measures
Primary care attachment and team-based primary care attachment in the 2 years before admission to provincial prison (baseline) and in the 2 years after release in 2010 (follow-up) for the prison release group, and for the corresponding periods for the general population group.
People in the prison release group (n=48861) were less likely to be attached to primary care compared with the age- and sex-matched general population group (n= 195444), at 58.9% versus 84.1% at baseline (P< .001) and 63.0% versus 84.4% during follow-up (P< .001), respectively. The difference in attachment to team-based primary care was small in magnitude but statistically significant, at 14.4% versus 16.1% at baseline (P< .001) and 19.9% versus 21.6% during follow-up (P< .001), respectively.
People who experience imprisonment have lower primary care attachment compared with the general population. Efforts should be made to understand barriers and to facilitate access to high-quality primary care for this population, including through initiatives to link people while in prison with primary care in the community.