PT  - JOURNAL ARTICLE
AU  - Shuldiner, Jennifer
AU  - Green, Michael E.
AU  - Kiran, Tara
AU  - Khan, Shahriar
AU  - Frymire, Eliot
AU  - Moineddin, Rahim
AU  - Kerr, Meghan
AU  - Tadrous, Mina
AU  - Nowak, Dominik Alex
AU  - Kwong, Jeffrey C.
AU  - Hu, Jia
AU  - Witteman, Holly O.
AU  - Hamilton, Bryn
AU  - Bogoch, Isaac
AU  - Marshall, Lydia-Joy
AU  - Ikura, Sophia
AU  - Bar-Ziv, Stacey
AU  - Kaplan, David
AU  - Ivers, Noah
TI  - Characteristics of primary care practices by proportion of patients unvaccinated against SARS-CoV-2: a cross-sectional cohort study
AID  - 10.1503/cmaj.230816
DP  - 2024 Apr 08
TA  - Canadian Medical Association Journal
PG  - E432--E440
VI  - 196
IP  - 13
4099  - http://www.cmaj.ca/content/196/13/E432.short
4100  - http://www.cmaj.ca/content/196/13/E432.full
SO  - CMAJ2024 Apr 08; 196
AB  - Background: Variations 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.Methods: We 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.Results: We 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.Interpretation: Primary 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.