Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 1 (1), 26-32

Patient-ly Waiting: A Review of Patient-Centered Access to Inflammatory Bowel Disease Care in Canada


Patient-ly Waiting: A Review of Patient-Centered Access to Inflammatory Bowel Disease Care in Canada

Holly Mathias et al. J Can Assoc Gastroenterol.


Canada has one of the highest prevalence estimates of inflammatory bowel disease (IBD) in the world. Like other chronic illnesses, access to specialist care is required for disease management. Traditionally, access to care is evaluated through wait times (actual access); however, new patient-oriented definitions of access (perceived access) highlight other equally important facets of access to care (e.g., appropriateness). Aim: How does access to gastroenterology speciality care influence disease-related outcomes for IBD patients in Canada? A comprehensive literature review was undertaken. Cochrane, PubMed and CINHAL databases were searched for peer-reviewed English language articles published between 2006 and 2016. Inclusion/exclusion criteria focussed on access to IBD care in Canada. Included articles were classified using Levesque et al.'s patient-centered access framework (e.g., affordability, accessibility, appropriateness, acceptability, availability and accommodation). Eight articles were found, including six which addressed patient-centered access. Most of the articles addressed issues of availability (e.g., wait times), appropriateness and affordability. Only one article addressed approachability and acceptability of IBD care. All articles emphasized a need for greater patient-centered measures (e.g., multidisciplinary clinics) with a goal to improve patient access and, ultimately, patient outcomes. Understanding patient-centered access to IBD care is important for managing IBD and improving patient outcomes. Literature examining access to gastroenterology services is limited. Increased investment in patient-oriented research should be made to better understand the relationship between access to specialist care and patient outcomes.

Keywords: health services accessibility; inflammatory bowel diseases; patient-centered care.


Figure 1.
Figure 1.
The Levesque et al. conceptual framework of patient-centered access (8). This framework examines the facets of perceived access (approachability, acceptability, availability and accommodation, affordability, and appropriateness) and their factors, which give greater insight into how patients experience access to health care services. The figure also presents the patient abilities that should be developed in order to improve access to services (e.g., ability to perceive). The facets of access and patient abilities are both used to develop how society understands the health care system. Note: Reproduced with permission from “Patient-centered access to health care: conceptualizing access at the interface of health systems and populations.” Copyright ©2013 by Levesque et al; licensee BioMed Central Ltd.

Similar articles

See all similar articles


    1. Podolsky DK. Inflammatory bowel disease. N Engl J Med 2002;347(6):417–29. - PubMed
    1. Longobardi T, Jacobs P, Wu L, Bernstein CN. Work losses related to inflammatory bowel disease in Canada: results from a National Population Health Survey. Am J Gastroenterol 2003;98(4):844–9. - PubMed
    1. Leddin D, Tamim H, Levy AR. Decreasing incidence of inflammatory bowel disease in eastern Canada: a population database study. BMC Gastroenterol 2014;14:140. - PMC - PubMed
    1. Crohn’s & Colitis Canada. What are Crohn’s & Colitis [CCC website] 2014. <>. (Accessed December 11, 2016).
    1. Bernstein CN, Wajda A, Svenson LW et al. The epidemiology of inflammatory bowel disease in Canada: a population-based study. Am J Gastroenterol 2006;101(7):1559–68. - PubMed

LinkOut - more resources