Survey on Access to Health Care and Pharmaceuticals During the Pandemic (SAHCPDP)

Detailed information for March 2020 to May 2021

The purpose of the Survey on Access to Health Care and Pharmaceuticals During the Pandemic is to better understand how health care service disruptions are affecting Canadians during the COVID-19 pandemic.

Data release - 23 November 2021

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

Description

The survey covers topics such as access to pharmaceuticals, impacts of delayed health care, barriers to receiving health care and general health status.

The data will be used by the Public Health Agency of Canada, Health Canada, the Canadian Institute for Health Information and other government organizations to inform the delivery of health services and support.

Reference period: The past 12 months

Subjects

• Health
• Health care services

Data sources and methodology

Target population

The target population for the survey is persons 18 years of age and older living in the ten provinces.

The observed population excludes: persons living on reserves and other Aboriginal settlements in the provinces and the institutionalized population.

Instrument design

The content for the survey was developed in collaboration with stakeholders at Health Canada, the Public Health Agency of Canada and Canadian Institute for Health Information.

The questionnaire underwent testing in the form of interviews in both of Canada's official languages, conducted by Statistics Canada's Questionnaire Design Resource Centre (QDRC). The goal of the testing was to test the questionnaire content.

Sampling

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

This is a sample survey with a stratified sample and cross-sectional design.
The survey combines two random samples.
The main sample is selected from a list frame of dwellings.
The Indigenous oversample is selected from the list of Indigenous respondents to Census 2016 who self-identified as Indigenous in order to target the Canadian Indigenous adult subpopulation.

Sampling unit
Both samples have a two-stage design: the sampling unit for the first stage is the dwelling, and the sampling unit for the second stage is the person.

Stratification method
The two frames were stratified by province and, for each frame, a simple random sample of sampling units was selected independently within each province.

Sampling and sub-sampling
The SAHCPDP sample has a two-stage design. First, dwellings will be randomly selected across Canada. Next, within each selected household, one individual aged 18 and over will be selected based on specific instructions within the letter they receive (or provided by the interviewer if they respond by phone). The instructions will use the age of household members to determine who is selected, and will vary from one household to another. For some households, the oldest member is selected, others the second oldest, or the youngest, etc. These letters are randomly assigned to the selected dwellings ensuring that the selected individual from within the dwelling is random.

For the Indigenous oversample, dwellings were randomly selected from amongst those containing at least one person who self-identified as Indigenous on the 2016 Census of Population. Within sampled dwellings, if multiple people self-identified as Indigenous on the 2016 Census of Population, one was chosen from among them at random.

The main sample of 40,000 dwellings is allocated provincially. Minimum sample sizes were determined that would ensure certain estimates would have acceptable sampling variability at the stratum level. Once these stratum sample size targets had been met, the remaining sample was allocated to the strata in a way that balanced the need for precision of both national-level and stratum-level estimates. This sample was representative of all households in the ten provinces.

The oversample of 15,000 Indigenous persons is allocated with the goal of producing equal quality estimates across ten provinces for the Indigenous subpopulation.

There is not necessarily a mutual exclusivity between these two samples, as respondents select from the dwelling frame may identify during collection that they are Indigenous. Conversely, respondents selected from the targeted oversample can identify as not being Indigenous during the SAHCPDP collection. These overlaps are treated during the weighting process.

Data sources

Data collection for this reference period: 2021-03-08 to 2021-05-15

Responding to this survey is voluntary.

Data are collected directly from survey respondents and extracted from administrative files.

Data are collected directly from survey respondents either through an electronic questionnaire (EQ) or through CATI (computer assisted telephone interviewing).

The only contact with dwellings is a letter sent through the mail. The letter informs people living at the sampled address that either a specific person or a randomly selected person has been chosen to participate in the survey. On the letter there is a code which gives access to the online questionnaire.

A Statistics Canada interviewer may call, email or text the respondent to do follow up if we do not receive the respondent's completed questionnaire.

Proxy reporting is allowed.
The questionnaire was developed in both official languages.
The electronic questionnaire takes 20 minutes to complete.

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

Error detection

Most editing of the data was performed at the time of collection by the collection application. It was not possible for respondents to enter out-of-range values and flow errors were avoided through programmed skip patterns. For example, the questionnaire ensured that questions that did not apply to the respondent were not asked.

In response to some types of inconsistent or unusual reporting, warning messages were invoked but no corrective action was taken at the time of the collection. Where appropriate, edits were instead developed to be performed after data collection at Head Office. Inconsistencies were usually corrected by setting one or both of the variables in question to "not stated".

Imputation

This methodology type does not apply to this statistical program.

Estimation

The estimation of population characteristics from a sample survey is based on the premise that each person in the sample represents a certain number of other persons in addition to themselves. This number is referred to as the survey weight. The process of computing survey weights for each survey respondent involves several steps.

As stated above, the SAHCPDP is a dual-frame survey with overlapping frames. One frame was derived using the Dwelling Universe File (DUF) to target all Canadians aged 18+ years old. The second frame (Target frame) was derived based on the 2016 Census long form respondents who self-identified as Indigenous in order to target the subpopulation of Canadian Indigenous people aged 18+ years old. The two frames were weighted independently until their respective person-respondent weights were derived, at which point the two files were integrated (adjusting the weights to account for the overlap in frame coverage) to obtain a person-level weight for the adult population. The final weighting steps of Winsorization and calibration were then applied.

Quality evaluation

While quality assurance mechanisms are applied at all stages of the statistical process, the validation and review of data by statisticians is the final verification of quality prior to release. Validation measures were implemented, they include:

a) verification of estimates through cross-tabulations
b) consultation with stakeholders internal to Statistics Canada
c) consultation with external stakeholders.

Disclosure control

Statistics Canada is prohibited by law from releasing any information it collects that could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. 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.

Revisions and seasonal adjustment

This methodology type does not apply to this statistical program.

Data accuracy

Survey errors come from a variety of different sources. One dimension of survey error is sampling error. Sampling error is defined as the error that arises because an estimate is based on a sample rather than the entire population. Sampling error can be expressed through a confidence interval or coefficient of variation.

Survey documentation is included with the microdata that instructs data users on the steps to define the confidence interval for population estimates.

Response rate:
In total, 54,715 of the selected units in the SAHCPDP were in-scope for the survey, out of which a response was obtained for 25,268 individuals, resulting in a response rate of 46.2%. The number of respondents identifying in SAHCPDP as Indigenous was 4,907.