Canadian Survey of Experiences with Primary Health Care (CSE-PHC)

Detailed information for 2006-2007

The general purpose of the survey is to measure Canadians' experiences with health care, specifically, experiences with various types of doctors and clinics, access to different types of health care including emergency room and prescription medication use. Special attention was given to respondents diagnosed with certain chronic conditions in terms of their general experiences and their participation in managing their own health care.

Data release - November 26, 2007 (A full report on the survey results is available from the Health Council of Canada.)

• Questionnaire(s) and reporting guide(s)
• Description
• Data sources and methodology
• Data accuracy
• Documentation

Description

The objectives of the CSE-PHC are to collect data on issues relating to experiences with health care that impact Canadians; to provide a picture of access and utilization of primary care; to provide information on issues specific to Canadians living with chronic conditions and their experiences with the health care system; and to provide information for the development of effective policies and strategies to help improve health care for all Canadians.

The CSE-PHC data can be used by researchers, non-governmental organizations, community planners, governments and the public. Results will provide a holistic perspective of Canadians' experiences with health care and identify as well as raise awareness about the issues that affect people living with chronic conditions. Also, the information collected by this survey will inform the decision-making process and provide data for the use of resources. It will also provide baseline data to monitor change over time.

Reference period: The gathered information is valid for the 12 months leading up to the interviews.

Subjects

• Health
• Health care services

Data sources and methodology

Target population

The survey was conducted with Canadians aged 18 years or older living in private dwellings in the 10 provinces and the three territories. Persons living on Indian Reserves or Crown lands, residents of institutions, full-time members of the Canadian Armed Forces and residents of certain remote regions are excluded from this survey.

Instrument design

The original version of the questionnaire, containing over 120 questions, was supplied by the client. This questionnaire was created by the Health Council by combining questions from other surveys conducted in the United States, Canada and other Commonwealth countries. The original version was reworked to harmonize concepts, definitions and reference periods. The new version also better reflected the research goals and objectives of the client. In addition, the number of questions where reduced and the flow of the interview was improved. The redesigned questionnaire was translated by Official Languages and Translation Division of Statistics Canada and tested in conjunction with Statistics Canada's Questionnaire Design and Review Centre (QDRC) using face to face interviews.

Sampling

This is a sample survey with a cross-sectional design.

The sample for this survey was drawn from the Canadian Community Health Survey (CCHS), Cycle 3.1 respondents (see record number 3226). The CCHS, Cycle 3.1 used two frames in combination: an area frame (based on the Labour Force Survey (LFS)) and a telephone frame. The sample for this survey consisted of 3,800 respondents selected from the area frame. Only the CCHS respondent, not the whole household, was eligible for selection. The population (of CCHS respondents) was stratified by Health Region (HR). Since only national estimates were required, the sample was allocated to each HR proportionately to its share of the total population aged 18 and over. Within a health region, the population was then ordered according to the LFS geography and a systematic sample was selected.

Data sources

Data collection for this reference period: 2007-01-16 to 2007-02-21

Responding to this survey is voluntary.

Data are collected directly from survey respondents.

An introductory letter and a pamphlet containing information on the Health Council of Canada were mailed to respondents approximately one week before data collection began. This was a paper/pencil survey conducted over the telephone, meaning the interviews were conducted by telephone and the respondents' answers to the questions were recorded manually on paper.

A front-end module of the questionnaire included a set of standard response codes for dealing with all possible call outcomes, as well as the associated scripts to be read by the interviewers. A standard approach set up for introducing the agency, the name and purpose of the survey, the survey sponsors, how the survey results will be used, and the duration of the interview was developed. We explained to respondents how they were selected for the survey, that their participation in the survey was voluntary, and that their information would remain strictly confidential. The data collection was conducted by specialized staff at the Statistics Canada head office in Ottawa. To manage and facilitate the collection process a computer-assisted telephone interview (CATI) automated scheduler system (BLAISE) was used for initial contact, follow-ups, managing appointments, etc. The system ensured that cases were assigned randomly to interviewers and that respondents were called at different times of the day and different days of the week to maximize the probability of contact.

Apart from a few exceptions, proxy responses were not allowed.

The average interview time was estimated to be 22 minutes. However, the length of the interviews varied depending on the circumstances of the respondent. For example, the average interview time is estimated to be 30 minutes for a respondent with chronic conditions and 8 to 13 minutes for those without chronic conditions. The overall average was closer to 30 minutes than the 22 originally estimated.

Completed questionnaires were sent for imaging and data capture.

View the Questionnaire(s) and reporting guide(s) .

Error detection

The first phase of error detection was done during the data collection. At that stage, the interviewer's supervisors reviewed the completed questionnaires. Observed inconsistencies were discussed with the interviewer who conducted the interview and the respondent was called back if required.

The second phase of error detection was conducted during data processing which was made up of many steps. The first was a general clean-up of the data to accomplish the following goals:
1) remove duplicate records from the file,
2) verify the collected data against the sample file,
3) identify missing records, and,
4) create a response file.

The editing phase of the data processing included top-down flow edits to clean up any paths that may have been mistakenly followed during the interview. This step was followed by analyzing frequency distributions to identify anomalies, for example missing or invalid categories or unusual frequencies.

Imputation

Since the data collected dealt with respondents' individual experiences with the health care system, imputation was not appropriate for most items. Consequently, missing data were coded as "Not stated".

Estimation

When a probability sample is used, as is the case for this survey, the principle behind estimation is that each person selected in the sample represents (in addition to himself/herself) several other persons not in the sample. For example, in a simple random sample of 2% of the population, each person in the sample represents 50 persons in the population. The number of persons represented by a given person in the sample is usually known as the weight or weighting factor of the sampled person and those weights should be taken into account to produce survey estimates that represent the whole population.

The CCHS Cycle 3.1 weights for the area frame, adjusted for non-response, are the starting point to create the weights for the CSE-PHC. Those weights are then adjusted for non-response to the actual survey, using the homogeneous response group theory. Then the weights are post-stratified so that the survey estimates for age (four age groups), sex and region (six regions) match the demographic projections as of January 20, 2007.

In addition to the estimation weights, 500 bootstrap weights have been created for the purpose of design-based variance estimation.

Quality evaluation

Quality assurance measures were implemented at every step of collection and processing. For example, measures such as the recruitment of qualified interviewers, proper training for specific survey concepts and procedures, observation of interviews to correct questionnaire design problems and instruction misinterpretations, procedures to ensure that data capture errors were minimized and edit quality checks to verify the processing logics were all put into place. Data are verified to ensure internal consistency.

Disclosure control

Statistics Canada is prohibited by law from releasing any data that would divulge information obtained under the Statistics Act that relates to any identifiable person, business or organization without the prior knowledge or the consent in writing of that person, business or organization. Various confidentiality rules are applied to all data that are released or published to prevent the publication or disclosure of any information deemed confidential. If necessary, data are suppressed to prevent direct or residual disclosure of identifiable data.

All names, addresses and telephone numbers were removed from the share data file. Since the data relates to personal experiences, there is no information that can be used to identify respondents. No Public Use Microdata File will be produced using these data.

Revisions and seasonal adjustment

This methodology does not apply to this survey.

Data accuracy

The response rate for the 2006-2007 CSE-PHC was 58.1%.

Please refer to Chapter 8.0 (Data Quality) of the Microdata User Guide for detailed information.

Documentation

• Microdata User Guide: The Canadian Survey of Experiences with Primary Health Care 2006-2007
  • Format: Microdata User Guide: The Canadian Survey of Experiences with Primary Health Care 2006-2007 - ARCHIVED - PDF, 361.11[ARCHIVED - PDF, 361.11 kb]