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Primary Care System Review: Impact of Priority Access

Priority Access, legislated in April 2002, has altered admission criteria to long-term care (LTC) from time prioritized to need based criteria. The purpose of this study was to assess residential care and resident acuity post Priority Access. The unchanged standard for physician coverage of one visit per two weeks assumes that residents' medical needs are similar.

However, the MSP regulations were designed for a medically stable population. The current regulation states that a patient must be "medically stable" prior to being transferred to LTC. Study findings include that physician participants indicated that 82% of the residents they care for are stable. The current standard of 1 visit per two weeks without additional paperwork requirements is appropriate for residents who are medically stable. However, 18% of residents cared for by a physician are typically unstable. Therefore, while the current standard is sufficient for the stable residents in LTC, it is not adequate for unstable residents and new admissions . The Centre for Healthy Aging at Providence examined available data sets and also indirect acuity indicators and concluded that resident acuity has increased within the Vancouver Coastal Health and that Priority Access appears to have contributed to this increase.

Residential care is caring for a larger proportion of IC3 and EC residents with the same staffing levels and the same MSP regulations for physician coverage.