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Family physicians providing regular care to residents in Ontario long-term care homes: characteristics and practice patterns

Lam JM, Anderson GM, Austin PC, Bronskill SE. Can Fam Physician. 2012; 58(11):1241-8.


Objective — To describe the characteristics and practice patterns of family physicians who regularly treat long-term care (LTC) residents in order to inform quality improvement strategies.

Design — Cross-sectional study involving a 2005 province-wide census of LTC residents' charts linked to additional health care administrative databases.

Setting — All LTC homes in Ontario.

Participants — Residents aged 66 years and older (n = 50375) and the family physicians (n = 1190) most responsible for their care.

Main Outcome Measures — Distribution of LTC residents across family physicians, and physician demographic characteristics and practice patterns.

Results — The distribution of residents across physicians was highly skewed (median 27 residents, mean 42.5 residents). The care of 90.4% of residents was accounted for by 628 (52.8%) identified physicians. Family physicians practising in LTC facilities were more likely to be older (mean age 52.4 years vs 48.2 years, P < .001) and male (82.4% vs 61.5%, P < .001) than other family physicians. Urban physicians who provided care to LTC residents had bigger LTC practices than rural LTC physicians did (median 50 residents vs median 12 residents).

Conclusion — About 600 family physicians are responsible for the regular care of more than 90% of LTC residents in Ontario and quality improvement efforts could be aimed at this relatively small group of physicians. Half of the urban physicians who practise in LTC homes are responsible for 50 or more LTC residents. This might represent a key part of their overall practice.

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Keywords: Long-term care Primary care/clinical practice

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