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Research ArticleResearch

Family physicians providing regular care to residents in Ontario long-term care homes

Characteristics and practice patterns

Jonathan M. Lam, Geoffrey M. Anderson, Peter C. Austin and Susan E. Bronskill
Canadian Family Physician November 2012, 58 (11) 1241-1248;
Jonathan M. Lam
Senior Data Analyst at Cancer Care Ontario.
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Geoffrey M. Anderson
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Peter C. Austin
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Susan E. Bronskill
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  • For correspondence: susan.bronskill@ices.on.ca
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    Figure 1

    Lorenz curve of the distribution of LTC residents across the family physicians who regularly provide care (Ontario, 2005)

    LTC—long-term care.

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    Table 1

    Characteristics of family physicians who regularly provided care to residents in LTC homes compared with all other family physicians in Ontario in 2005

    CHARACTERISTICSMRPs IN LTC HOMES (N = 1190)REMAINING FPs (n = 9127)PVALUE
    Demographic characteristics
      • Age, y
       -Mean (SD)52.4 (10.5)48.2 (1.9)< .001
       -Median (IQR)52 (45–59)47 (39–56)< .001
      • Male sex, n (%)980 (82.4)5598 (61.3)< .001
      • Community size by no. of individuals, n (%)
       -< 9000290 (24.4)750 (8.2)< .001
       -9000–99 999177 (14.9)811 (8.9)
       -100 000–499 999267 (22.4)1986 (21.8)
       -500 000–1 249 999149 (12.5)1367 (15.0)
       -≥ 1 250 000304 (25.5)4055 (44.4)
      • Canadian medical graduate, n (%)968 (81.3)6943 (76.0)< .001
    Practice patterns
      • Total visits
       -Mean (SD)7983.8 (4128.9)5092.1 (3906.5)< .001
       -Median (IQR)7366 (5227–10 253)4474 (2166–7348)< .001
      • Percentage of practice made up of LTC home visits
       -Mean (SD)23.1 (24.0)0.7 (5.7)< .001
       -Median (IQR)15.4 (3.6–35.3)0 (0–0)< .001
      • Percentage of practice made up of office visits
       -Mean (SD)67.1 (23.4)87.1 (26.5)< .001
       -Median (IQR)72.4 (55.3–84.7)99.8 (90.6–100)< .001
      • Percentage of practice made up of emergency department visits
       -Mean (SD)2.9 (7.8)6.5 (21.1)< .001
       -Median (IQR)0 (0–0)0 (0–0)< .001
      • Percentage of practice made up of home visits
       -Mean (SD)0.4 (1.2)0.4 (4.0).982
       -Median (IQR)0.1 (0–0.4)0 (0–0)< .001
      • Percentage of practice made up of hospital visits
       -Mean (SD)6.3 (9.0)5.2 (15.3).009
       -Median (IQR)3.2 (0–10.3)0 (0–2.2)< .001
      • Number of obstetric deliveries
       -Mean (SD)2.8 (11.0)2.4 (12.2).313
       -Median (IQR)0 (0–0)0 (0–0)< .001
       -At least 1 obstetric delivery, n (%)135 (11.3)691 (7.6)< .001
      • Anesthesia payment, $
       -Mean (SD)1527.0 (11 006.7)2261.8 (26 169.0).338
       -Median (IQR)0 (0–0)0 (0–0).068
       -Any anesthesia payment, n (%)100 (8.4)636 (7.0)< .001
    • IQR—interquartile range, LTC—long-term care, MRP—most responsible physician.

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    Table 2

    Characteristics of family physicians who regularly provided care to residents in LTC homes stratified by community size in Ontario in 2005

    PHYSICIAN CHARACTERISTICSOVERALL (N = 1190)POPULATION OF MAIN COMMUNITY SERVED
    < 9000 (N = 290)9000–99 999 (N = 177)100 000–499 999 (N = 267)500 000–1 249 999 (N = 149)≥1 250 000 (N = 304)
    Demographic characteristics
      • Male sex, n (%)979 (82.3)235 (81.0)152 (85.9)231 (86.5)118 (79.2)243 (79.9)
      • Age, y, mean (SD)52.4 (10.5)51.8 (10.1)52.6 (10.3)52.7 (10.4)53.0 (10.8)52.7 (10.7)
      • Canadian medical graduate, n (%)968 (81.3)240 (82.8)142 (80.2)216 (80.9)124 (83.2)241 (79.3)
    Practice patterns
      • No. of LTC residents per MRP, median (IQR)27 (7–59)12 (5–30)12 (4–46)32 (5–64)34 (13–62)50 (23–85)
      • No. of LTC homes per MRP, mean (SD)1.5 (0.9)1.3 (0.6)1.6 (0.8)1.6 (0.9)1.6 (0.8)1.7 (1.2)
      • No. of visits per LTC resident per MRP, mean (SD)2.6 (1.3)1.9 (1.1)2.0 (1.1)2.5 (1.3)2.7 (1.3)3.5 (1.1)
      • Percentage of visits to LTC homes, mean (SD)23.1 (24.0)13.0 (17.9)1 5.9 (21.4)21.8 (21.4)31.2 (29.1)34.1 (24.3)
      • Percentage of visits to emergency departments, mean (SD)2.9 (7.8)7.6 (11.2)2.6 (7.3)1.6 (5.6)0.6 (4.7)0.9 (4.9)
      • Percentage of visits to homes, mean (SD)0.4 (1.2)0.5 (0.9)0.3 (0.7)0.5 (1.4)0.5 (1.3)0.4 (1.5)
      • Percentage of visits to hospitals, mean (SD)6.3 (9.0)8.8 (6.3)10.1 (7.6)5.9 (7.9)4.1 (11.5)3.4 (10.1)
      • Percentage of visits in offices, mean (SD)67.1 (23.4)70.1 (18.8)71.0 (21.2)70.2 (21.9)63.7 (30.0)61.0 (24.9)
      • Number of obstetric deliveries, mean (SD)2.8 (11.0)3.8 (11.9)5.4 (15.5)2.0 (9.9)3.6 (12.4)0.7 (5.2)
       -Any obstetric delivery, n (%)135 (11.3)60 (20.7)26 (14.7)21 (7.9)16 (10.7)12 (3.9)
      • Anesthesia payment, $, mean (SD)1527.0 (11 006.7)2983.9 (12 623.3)2938.9 (17 371.1)615.4 (8293.2)1423.6 (12 252.2)181.6 (2941.8)
       -Any anesthesia payment, n (%)100 (8.4)40 (13.8)13 (7.3)12 (4.5)7 (4.7)28 (9.2)
      • Total number of all annual visits, mean (SD)7983.8 (4128.9)6401.2 (3054.1)8313.4 (4231.9)8567.2 (4181.0)6773.9 (3151.5)9425.4 (4652.0)
    • IQR—interquartile range, LTC—long-term care, MRP—most responsible physician.

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Canadian Family Physician: 58 (11)
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Family physicians providing regular care to residents in Ontario long-term care homes
Jonathan M. Lam, Geoffrey M. Anderson, Peter C. Austin, Susan E. Bronskill
Canadian Family Physician Nov 2012, 58 (11) 1241-1248;

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