• Jennifer Shuldiner, Michael E Green, Tara Kiran, Shahriar Khan, Eliot Frymire, Rahim Moineddin, Meghan Kerr, Mina Tadrous, Dominik Alex Nowak, Jeffrey C Kwong, Jia Hu, Holly O Witteman, Bryn Hamilton, Isaac Bogoch, Lydia-Joy Marshall, Sophia Ikura, Stacey Bar-Ziv, David Kaplan, and Noah Ivers.
• Women's College Hospital Institute of Virtual Care and Systems Solutions (Shuldiner, Tadrous, Ivers), Women's College Hospital, Toronto, Ont.; Departments of Family Medicine and Public Health Sciences (Green, Kerr), Queen's University, Kingston, Ont.; ICES (Green, Khan, Moineddin, Tadrous, Kwong, Ivers); Department of Family and Community Medicine (Kiran, Nowak, Kwong), University of Toronto; St. Michael's Hospital (Kiran), Unity Health Toronto; MAP Centre for Urban Health Solutions (Kiran), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre for Health Services and Policy Research (Frymire), Queen's University, Kingston, Ont.; Leslie Dan School of Pharmacy (Tadrous), and Dalla Lana School of Public Health (Nowak), University of Toronto; Women's College Hospital Academic Family Health Team (Nowak), Women's College Hospital; Public Health Ontario (Kwong); University Health Network (Kwong), Toronto, Ont.; Department of Community Health Sciences (Hu), University of Calgary, Calgary, Alta.; VITAM Research Centre for Sustainable Health (Witteman); Department of Family and Emergency Medicine (Witteman), Université Laval, Québec, Que.; Association of Family Health Teams of Ontario (Hamilton); Department of Medicine (Bogoch), University of Toronto; Health Commons Solutions Labs Ontario (Marshall, Ikura); Ontario Health (Bar-Ziv, Kaplan); Institute of Health Policy, Management and Evaluation (Ivers), University of Toronto, Toronto, Ont. jennifer.shuldiner@wchospital.ca.
• CMAJ. 2024 Apr 7; 196 (13): E432E440E432-E440.

BackgroundVariations in primary care practices may explain some differences in health outcomes during the COVID-19 pandemic. We sought to evaluate the characteristics of primary care practices by the proportion of patients unvaccinated against SARS-CoV-2.MethodsWe conducted a population-based, cross-sectional cohort study using linked administrative data sets in Ontario, Canada. We calculated the percentage of patients unvaccinated against SARS-CoV-2 enrolled with each comprehensive-care family physician, ranked physicians according to the proportion of patients unvaccinated, and identified physicians in the top 10% (v. the other 90%). We compared characteristics of family physicians and their patients in these 2 groups using standardized differences.ResultsWe analyzed 9060 family physicians with 10 837 909 enrolled patients. Family physicians with the largest proportion (top 10%) of unvaccinated patients (n = 906) were more likely to be male, to have trained outside of Canada, to be older, and to work in an enhanced fee-for-service model than those in the remaining 90%. Vaccine coverage (≥ 2 doses of SARS-CoV-2 vaccine) was 74% among patients of physicians with the largest proportion of unvaccinated patients, compared with 87% in the remaining patient population. Patients in the top 10% group tended to be younger and live in areas with higher levels of ethnic diversity and immigration and lower incomes.InterpretationPrimary care practices with the largest proportion of patients unvaccinated against SARS-CoV-2 served marginalized communities and were less likely to use team-based care models. These findings can guide resource planning and help tailor interventions to integrate public health priorities within primary care practices.© 2024 CMA Impact Inc. or its licensors.

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