Assessing the Experiences of Immigrants Receiving Primary Care during COVID-19: A mixed-methods study
Date
2022-01
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Abstract
Background: The entire healthcare system, including primary healthcare (PHC) services, has been disrupted since the onset of the COVID-19 pandemic. As the crisis threatens all citizens significantly, further barriers to accessing care exist for those who are most vulnerable, experience marginalization, and have pre-existing challenges. We aimed to explore immigrants’ lived experiences in accessing and receiving PHC services during the pandemic. Methods: A multiphase mixed-methods study using a sequential explanatory design was employed. The first study includes a systematic review that synthesizes the evidence on the experiences that immigrant patients have receiving PHC. Study two provides insights from a recently employed “COVID-19 Experiences and Impacts Survey” data and compares the experiences of Albertans that were born in and outside Canada. Descriptive statistics and multivariable logistic regression were performed, using STATA. The third study is a qualitative inquiry that aims to gain a deeper understanding of the newcomers’ (living in Canada ≤5 years) and providers’ experiences in PHC during the pandemic. A thematic analysis was applied, using NVivo software. Results: The literature review revealed four major concerns affecting healthcare experiences of immigrant patients: 1) cultural and linguistic difference; 2) socioeconomic challenges; 3) health system factors; and 4) patient-provider relationship. The quantitative analysis of survey data (N=10,175) showed Canadian-born respondents were more likely to report worsening mental health during the pandemic, as well as higher levels of perceived stress, anxiety, or depression compared to non-Canadian-born survey respondents. In addition, Canadian-born respondents were more likely to prefer virtual healthcare compared to those respondents born outside Canada. Both cohorts reported that delayed care during the pandemic negatively impacted their health, and similar percentages in each cohort reported hesitancy getting the COVID-19 Vaccine. The qualitative inquiry included 23 interviews (15 newcomers, 8 providers) and revealed three aspects driving newcomers’ and healthcare providers’ experiences: overall experiences (doctor-patient relationship, care coordination, expectation on care), virtual care experience (accessibility, communication), challenges in accessing and receiving healthcare (language/cultural difference, care accessibility, health system literacy, competing priorities). Conclusion: This thesis presents a comprehensive exploration and description of immigrants’ lived experiences in accessing and receiving PHC during the pandemic. Immigrants reported many challenges in accessing and receiving PHC, and these challenges have been increased since the COVID-19 pandemic. The results of this thesis yielded six recommendations that can inform PHC quality improvement initiatives and PHC policy.
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Keywords
Primary Healthcare, COVID-19, Pandemic, Virtual Care, Newcomers, Healthcare Providers, Patient Experiences, Access to Healthcare, Access Barriers, Canada
Citation
Bajgain, B. (2022). Assessing the experiences of immigrants receiving primary care during COVID-19: a mixed-methods study (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.