RT Journal Article
SR Electronic
T1 Trends in Providing Out-of-Office, Urgent After-Hours, and On-Call Care in British Columbia
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 116
OP 124
DO 10.1370/afm.2366
VO 17
IS 2
A1 Hedden, Lindsay
A1 Lavergne, M. Ruth
A1 McGrail, Kimberlyn M.
A1 Law, Michael R.
A1 Bourgeault, Ivy L.
A1 McCracken, Rita
A1 Barer, Morris L.
YR 2019
UL http://www.annfammed.org/content/17/2/116.abstract
AB PURPOSE Providing care in alternative (non-office) locations and outside office hours are important elements of access and comprehensiveness of primary care. We examined the trends in and determinants of the services provided in a cohort of primary care physicians in British Columbia, Canada.METHODS We used physician-level payments for all primary care physicians practicing in British Columbia from 2006-2007 through 2011-2012. We examined the association between physician demographics and practice characteristics and payment for care in alternative locations and after hours across rural, urban, and metropolitan areas using longitudinal mixed-effects models.RESULTS The proportion of physicians who provided care in alternative locations and after hours declined significantly during the period, in rural, urban, and metropolitan practices. Declines ranged from 5% for long-term care facility visits to 22% for after-hours care. Female physicians, and those in the oldest age category, had lower odds of providing care at alternative locations and for urgent after-hours care. Compared with those practicing in metropolitan centers, physicians working in rural areas had significantly higher odds of providing care both in alternative locations and after hours.CONCLUSION Care provided in non-office locations and after office hours declined significantly during the study period. Jurisdictions where providing these services are not mandated, and where similar workforce demographic shifts are occurring, may experience similar accessibility challenges.