Time to finding a regular primary care provider for unattached patients at the Primary Care Diabetes Support Program in London, Ontario, Canada.

OBJECTIVE: The Primary Care Diabetes Support Program (PCDSP) at St. Joseph's Health Care in London, Ontario, focuses on managing diabetes in high-risk adults (e.g., socially and medically complex) and works to attach patients to a regular primary care provider. We described the characteristics of the unattached patient population at the PCDSP and identified time to and predictors of attachment (i.e., finding a regular provider). METHODS: We conducted a retrospective cohort study using electronic medical record data of patients enrolled at the PCDSP between April 1, 2011, and March 31, 2018 and followed patients for 5 years. We used descriptive statistics to assess characteristics of patients and time-to-event analyses to assess time to attachment. RESULTS: Among a final cohort of 726 patients with 5-year follow-up data, 401 individuals (55.2%) became attached. The estimated median time to attachment was 998 days (95%Confidence Interval [CI] 748-1248). Individuals who were both socially and medically complex (Hazard Ratio [HR]=1.44; 95% CI 1.01 to 2.06) and joined the PCDSP in fiscal 2012 (HR=1.40; 95%CI 1.01-1.95), were more likely to be attached compared to those who were non-complex and joined the program in fiscal 2011, respectively. CONCLUSION: The PCDSP prioritizes high-risk patients, particularly those who are both medically and socially complex, to attach them with a regular primary care provider. Our findings may relate to the social-support workers in the program who play a crucial role in documenting social risk indicators, prioritizing high-risk patients, and advocating for their attachment to primary care.