Healthcare Access and Diagnostic Imaging Care Pathways for Musculoskeletal Conditions in Canada: A Cross-Sectional Analysis of the Canadian Community Health Survey 2022

Background: Musculoskeletal conditions represent a major source of disability and healthcare use worldwide. Access to primary care plays an important role in the clinical evaluation and management of these conditions, including decisions related to diagnostic assessment and referral. Understanding factors associated with access to a regular healthcare provider may help identify population groups that experience differences in primary care engagement. Objective: This study aims to examine healthcare access and utilization among Canadians with musculoskeletal conditions and identify demographic and health-related factors associated with having a regular healthcare provider. Methods: This cross-sectional study used data from the 2022 Canadian Community Health Survey public use microdata file. The analysis included 19,460 respondents aged 18 years and older reporting musculoskeletal conditions, representing approximately 6.8 million Canadians after application of survey weights. Descriptive statistics were calculated using weighted counts and row percentages. Survey-weighted logistic regression was used to evaluate factors associated with having a regular healthcare provider while accounting for the complex survey design. Results: Most respondents reported having a regular healthcare provider. Higher odds were observed among those aged ≥ 65 years (adjusted odds ratio: 1.61, 95% confidence interval: 1.04-2.50, p = 0.033), those with overweight or obesity (1.19, 1.04-1.36, p = 0.012), and those with hypertension (1.29, 1.13-1.48, p < 0.001). Lower odds were associated with cardiovascular disease (0.77, 0.64-0.92, p = 0.004) and disability (0.75, 0.65-0.86, p < 0.001). Other variables were not statistically significant. Conclusion: This study highlights differences in primary care access among Canadians with musculoskeletal conditions. Identifying groups with lower access to regular providers may help guide strategies aimed at improving continuity of care and supporting appropriate diagnostic evaluation.