Although not synonymous with the strict definitions of a medical home, having an ongoing relationship with either a primary care facility or an individual provider, a "usual source of care" (USC), is associated with better access to health care and reports of increased preventive services, decreased use of emergency services, and shorter hospital stays (14– 14).
Odds of CRC screening increased with being married, having a higher level of income, having a higher level of acculturation, having health insurance, a usual source of care and a doctor's visit within the past year.
High unmet healthcare needs despite relatively good indicators of access to healthcare (having a usual source of outpatient care, a regular medical doctor and a provincial health card) identified in this population suggest that discrimination may be an important determinant of access to healthcare among disadvantaged patients.
Although the majority of respondents had a regular medical doctor (66%), a usual source of outpatient care (90%), and a provincial health card (93%, 400% reported unmet healthcare needs.> -wrap-foot> Column totals may not add to the total sample size because of missing data.
This would also make it difficult to establish a usual source of care and form a relationship with a medical provider that can lead to an enhanced patient-provider relationship.
Continuity of care, a term to describe a usual source of care where children receive preventive services over time, has been found to be associated with improved overall utilization of medical services, better health outcomes, and increased use of preventive care [ 10- 14].
More complex access issues, such as knowledge about the need for CRC screening, having a usual source of care, receiving a physician recommendation for CRC screening, mistrust of physicians and the health care system [ 16, 17], which have been linked to CRC screening compliance in other underserved populations have yet to be explored among sexual minority populations.
People reporting no utilisation of services over a two-year period were classified as not having a usual source of care despite reporting having a personal family doctor.
These 2 categories of respondents e.g. those with a primary care provider versus those who speak about a usual source of care who might be a specialist may differ considerably, and comparing them may be misleading.
In general, people without a usual source of primary healthcare, those reporting a solo practice and a family medicine group report lower levels of unmet needs in bivariate analyses.
