The effects of a primary care clinic closure on patients: a prospective observational study

Objective: To examine the effect of a primary care clinic closure on patients’ access to health care and on patient physical and mental health. Methods: A prospective cohort study. Within one month of the closure of a primary care clinic in the Central Coast region, NSW, Australia, all clinic patients aged 16 years or older were invited to participate in the study via completion of baseline and 6-month follow-up surveys which included items on demographics, medical history, access to health services, physical and mental health and perceived effects of the clinic closure. Univariate analyses were conducted via paired t-tests for continuous variables and chi squared tests for categorical variables. Multivariate analysis was conducted using multiple logistic and linear regression models. Results: The baseline survey was completed by 214 participants, with 150 participants completing the follow-up survey. The majority of participants (79%) had found a new regular GP within 6 months of the clinic closure. On multivariate analysis, having not found a new regular GP was associated with reporting reduced use of primary care services and problems with access to primary care services in the six months following the closure. Participants without a regular GP reported the clinic closure having greater negative impact on their access to health services and their physical and emotional health. Discussion: Patients without a usual source of care have reduced access to health services with associated delays in seeking health care, which could potentially have serious consequences. Patients who remain unattached to a PCP have lower self-rated general health and perceive that the clinic closure had a greater impact on their physical and emotional health. Conclusion: The clinic closure had significant impacts on a sub-set of patients who were not able to locate a new regular GP in the following six months. Implications: There is scope for a systems approach to facilitate patient transition between primary care practices.