{"id":{"repo_id":"brock","oai_identifier":"oai:brocku.scholaris.ca:10464/20006"},"canonical_url":"https://search.dev.ndltd.org/etd/brock/oai:brocku.scholaris.ca:10464/20006","repository":{"repo_id":"brock","name":"Brock University","base_url":"https://brocku.scholaris.ca/server/oai/request"},"display":{"title":"The Role of System-Level Primary Care Characteristics and Immigration Status as Predictors of Non-Urgent Emergency Department Presentations","abstract":"Non-urgent health conditions are best served in primary care settings (e.g. family practices and walk-in clinics). Despite this, patients commonly present to emergency departments (EDs) for non-urgent conditions, especially with upper respiratory tract infections (URTIs). This leads to poor patient health outcomes and greater healthcare system costs. Immigrants also use EDs non-urgently at a greater rate than non-immigrants. To further our understanding of factors associated with non-urgent ED use, a systematic review on system-level primary care provider (PCP) characteristics associated with non-urgent ED presentations and a study on the association between new immigrant status and non-urgent URTI ED presentations were conducted. Two studies were conducted: a systematic review of quantitative studies published between January 1, 2000, and February 12, 2025, on the associations between system-level PCP characteristics and non-urgent ED presentations; and a population-based cohort study (n=13,232,410) on the associations between immigration status and immigrant-related characteristics with non-urgent URTI ED presentations in Ontario. A total of 37 quantitative studies were identified between January 1, 2000 and February 12, 2025 that focused on the association between system-level PCP characteristics and non-urgent ED presentations globally (i.e., Canada=10, USA=10, Europe=10, Asia/Oceania=6, South America=1). Across these studies, four categories of PCP characteristics were revealed: decreased PCP availability, greater distance to PCPs, poor quality of care, and varying PCP care/payment models. In the cohort study, new immigrants to Ontario were 14% (relative risk [RR]=0.86, 95% confidence interval [CI] 0.82-0.90) less likely to make non-urgent URTI ED presentations versus non-immigrants. Immigrants whose mother tongue was Punjabi or who originated from India or the Philippines were less likely to make non-urgent URTI ED presentations. Conversely, Francophone and non-English/French-speaking immigrants, refugees, and those with capitated PCPs were more likely to make non-urgent URTI ED presentations. Increasing PCP availability, PCP proximity to patients, improving the quality of PCP care, and using patient enrolment and team-based models could offset non-urgent ED presentations. Decreased non-urgent URTI ED presentations by immigrants may demonstrate the healthy immigrant effect or learned healthcare-seeking behaviour. Francophone and non-official language-speaking immigrants, refugees, and patients of capitated PCPs may benefit from greater PCP access.","abstract_html":"Non-urgent health conditions are best served in primary care settings (e.g. family practices and walk-in clinics). Despite this, patients commonly present to emergency departments (EDs) for non-urgent conditions, especially with upper respiratory tract infections (URTIs). This leads to poor patient health outcomes and greater healthcare system costs. Immigrants also use EDs non-urgently at a greater rate than non-immigrants. To further our understanding of factors associated with non-urgent ED use, a systematic review on system-level primary care provider (PCP) characteristics associated with non-urgent ED presentations and a study on the association between new immigrant status and non-urgent URTI ED presentations were conducted. Two studies were conducted: a systematic review of quantitative studies published between January 1, 2000, and February 12, 2025, on the associations between system-level PCP characteristics and non-urgent ED presentations; and a population-based cohort study (n=13,232,410) on the associations between immigration status and immigrant-related characteristics with non-urgent URTI ED presentations in Ontario. A total of 37 quantitative studies were identified between January 1, 2000 and February 12, 2025 that focused on the association between system-level PCP characteristics and non-urgent ED presentations globally (i.e., Canada=10, USA=10, Europe=10, Asia/Oceania=6, South America=1). Across these studies, four categories of PCP characteristics were revealed: decreased PCP availability, greater distance to PCPs, poor quality of care, and varying PCP care/payment models. In the cohort study, new immigrants to Ontario were 14% (relative risk [RR]=0.86, 95% confidence interval [CI] 0.82-0.90) less likely to make non-urgent URTI ED presentations versus non-immigrants. Immigrants whose mother tongue was Punjabi or who originated from India or the Philippines were less likely to make non-urgent URTI ED presentations. Conversely, Francophone and non-English/French-speaking immigrants, refugees, and those with capitated PCPs were more likely to make non-urgent URTI ED presentations. Increasing PCP availability, PCP proximity to patients, improving the quality of PCP care, and using patient enrolment and team-based models could offset non-urgent ED presentations. Decreased non-urgent URTI ED presentations by immigrants may demonstrate the healthy immigrant effect or learned healthcare-seeking behaviour. Francophone and non-official language-speaking immigrants, refugees, and patients of capitated PCPs may benefit from greater PCP access.","abstract_has_math":false,"creators":["DiDomenico, Antonio (Tony) Benito Sante"],"institution":"Brock University","degree_name":"M.Sc. Applied Health Sciences","degree_level":"Master","degree_discipline":"Faculty of Applied Health Sciences","degree_department":"Applied Health Sciences Program","school":null,"contributors":[],"advisors":["Hajna, Samantha"],"committee_chairs":[],"committee_members":[],"year":2026,"date_issued":"2026-01-29","date_published":"2026-01-29","updated_at":"2026-07-24T01:23:07Z","subjects":["INTERDISCIPLINARY RESEARCH AREAS::Health and medical services in society","MEDICINE::Social medicine::Public health medicine research areas::Family medicine","MEDICINE::Social medicine::Public health medicine research areas::Epidemiology","MEDICINE::Social medicine::Public health medicine research areas::Public health science","MEDICINE::Social medicine::Public health medicine research areas::Community medicine"],"languages":["eng"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/10464/20006","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Hajna, Samantha"]},{"key":"dc:contributor.department","label":"Department","values":["Applied Health Sciences Program"]},{"key":"dc:creator","label":"Author","values":["DiDomenico, Antonio (Tony) Benito Sante"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2026-01-30T20:54:18Z"]},{"key":"dc:date.issued","label":"Date","values":["2026-01-29"]},{"key":"dc:publisher","label":"Institution","values":["Brock University"]},{"key":"dc:type","label":"Dc Type","values":["Electronic Thesis or Dissertation"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Faculty of Applied Health Sciences"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Master"]},{"key":"thesis:degree_name","label":"Degree Name","values":["M.Sc. 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Despite this, patients commonly present to emergency departments (EDs) for non-urgent conditions, especially with upper respiratory tract infections (URTIs). This leads to poor patient health outcomes and greater healthcare system costs. Immigrants also use EDs non-urgently at a greater rate than non-immigrants. To further our understanding of factors associated with non-urgent ED use, a systematic review on system-level primary care provider (PCP) characteristics associated with non-urgent ED presentations and a study on the association between new immigrant status and non-urgent URTI ED presentations were conducted. Two studies were conducted: a systematic review of quantitative studies published between January 1, 2000, and February 12, 2025, on the associations between system-level PCP characteristics and non-urgent ED presentations; and a population-based cohort study (n=13,232,410) on the associations between immigration status and immigrant-related characteristics with non-urgent URTI ED presentations in Ontario. A total of 37 quantitative studies were identified between January 1, 2000 and February 12, 2025 that focused on the association between system-level PCP characteristics and non-urgent ED presentations globally (i.e., Canada=10, USA=10, Europe=10, Asia/Oceania=6, South America=1). Across these studies, four categories of PCP characteristics were revealed: decreased PCP availability, greater distance to PCPs, poor quality of care, and varying PCP care/payment models. In the cohort study, new immigrants to Ontario were 14% (relative risk [RR]=0.86, 95% confidence interval [CI] 0.82-0.90) less likely to make non-urgent URTI ED presentations versus non-immigrants. Immigrants whose mother tongue was Punjabi or who originated from India or the Philippines were less likely to make non-urgent URTI ED presentations. Conversely, Francophone and non-English/French-speaking immigrants, refugees, and those with capitated PCPs were more likely to make non-urgent URTI ED presentations. Increasing PCP availability, PCP proximity to patients, improving the quality of PCP care, and using patient enrolment and team-based models could offset non-urgent ED presentations. Decreased non-urgent URTI ED presentations by immigrants may demonstrate the healthy immigrant effect or learned healthcare-seeking behaviour. Francophone and non-official language-speaking immigrants, refugees, and patients of capitated PCPs may benefit from greater PCP access."]},{"key":"dc:title","label":"Title","values":["The Role of System-Level Primary Care Characteristics and Immigration Status as Predictors of Non-Urgent Emergency Department Presentations"]}]}],"canonical_facts":{"dc:contributor.advisor":["Hajna, Samantha"],"dc:contributor.department":["Applied Health Sciences Program"],"dc:creator":["DiDomenico, Antonio (Tony) Benito Sante"],"dc:date.accessioned":["2026-01-30T20:54:18Z"],"dc:date.issued":["2026-01-29"],"dc:description.abstract":["Non-urgent health conditions are best served in primary care settings (e.g. family practices and walk-in clinics). Despite this, patients commonly present to emergency departments (EDs) for non-urgent conditions, especially with upper respiratory tract infections (URTIs). This leads to poor patient health outcomes and greater healthcare system costs. Immigrants also use EDs non-urgently at a greater rate than non-immigrants. To further our understanding of factors associated with non-urgent ED use, a systematic review on system-level primary care provider (PCP) characteristics associated with non-urgent ED presentations and a study on the association between new immigrant status and non-urgent URTI ED presentations were conducted. Two studies were conducted: a systematic review of quantitative studies published between January 1, 2000, and February 12, 2025, on the associations between system-level PCP characteristics and non-urgent ED presentations; and a population-based cohort study (n=13,232,410) on the associations between immigration status and immigrant-related characteristics with non-urgent URTI ED presentations in Ontario. A total of 37 quantitative studies were identified between January 1, 2000 and February 12, 2025 that focused on the association between system-level PCP characteristics and non-urgent ED presentations globally (i.e., Canada=10, USA=10, Europe=10, Asia/Oceania=6, South America=1). Across these studies, four categories of PCP characteristics were revealed: decreased PCP availability, greater distance to PCPs, poor quality of care, and varying PCP care/payment models. In the cohort study, new immigrants to Ontario were 14% (relative risk [RR]=0.86, 95% confidence interval [CI] 0.82-0.90) less likely to make non-urgent URTI ED presentations versus non-immigrants. Immigrants whose mother tongue was Punjabi or who originated from India or the Philippines were less likely to make non-urgent URTI ED presentations. Conversely, Francophone and non-English/French-speaking immigrants, refugees, and those with capitated PCPs were more likely to make non-urgent URTI ED presentations. Increasing PCP availability, PCP proximity to patients, improving the quality of PCP care, and using patient enrolment and team-based models could offset non-urgent ED presentations. Decreased non-urgent URTI ED presentations by immigrants may demonstrate the healthy immigrant effect or learned healthcare-seeking behaviour. Francophone and non-official language-speaking immigrants, refugees, and patients of capitated PCPs may benefit from greater PCP access."],"dc:identifier.uri":["https://hdl.handle.net/10464/20006"],"dc:language.iso":["eng"],"dc:publisher":["Brock University"],"dc:subject":["INTERDISCIPLINARY RESEARCH AREAS::Health and medical services in society","MEDICINE::Social medicine::Public health medicine research areas::Family medicine","MEDICINE::Social medicine::Public health medicine research areas::Epidemiology","MEDICINE::Social medicine::Public health medicine research areas::Public health science","MEDICINE::Social medicine::Public health medicine research areas::Community medicine"],"dc:title":["The Role of System-Level Primary Care Characteristics and Immigration Status as Predictors of Non-Urgent Emergency Department Presentations"],"dc:type":["Electronic Thesis or Dissertation"],"thesis:degree_discipline":["Faculty of Applied Health Sciences"],"thesis:degree_level":["Master"],"thesis:degree_name":["M.Sc. 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