The following is a summary of “Characteristics of Family Physicians Delivering Home Visits: A Canadian Retrospective Cohort Study,” published in the February 2023 issue of Pain Management by Scott, et al.
Despite evidence that they increase healthcare quality and save costs overall, home visits were becoming less prevalent. For a study, researchers sought to identify the primary care doctors in Ontario, Canada, who provided end-of-life home visits for patients, characterized the traits of primary care doctors who provide end-of-life home visits, and investigated correlations with delivery. Find out which primary care doctors in Ontario, Canada, were providing end-of-life home visits for patients, what made a primary care doctor give an end-of-life home visit, and what links there were with delivery.
It was a retrospective cohort design utilizing ICES-hosted population-level administrative health data. The cohort was made up of primary care doctors who practiced in Ontario, Canada, between April 1, 2014, and March 31, 2019, and who were enrolled in the College of Physicians and Surgeons of Ontario database dataset as of March 31, 2016, or on or after January 1, 1990.
There were 9,884 doctors in all, 2,568 (25.7%) of whom provided at least one end-of-life home visit. Physician characteristics that increased the odds ratio (OR) of home visit delivery were older age (OR 1.01 [95% CI: 1.00-1.02]), international training (OR 1.28 [95% CI:1.04-1.59]), previous home visit experience (OR 1.02 [95% CI: 1.01-1.02]), capitation models of remuneration; specifically enhanced fee-for-service models (OR 1.5 [95% CI: 1.17-2.00]) and primarily capitation model (OR 1.4 [95% CI:1.11–1.79]), and population size of practice location with highest odds in small rural or remote areas (<9000 residents) (OR 1.38 [95%CI: 1.02–1.88]) and large metropolitan areas (OR 1.84 [95%CI: 1.46–2.57]).
The study validated earlier findings while also identifying new features of primary care physicians related to home visit practice patterns. It also identified traits that may be improved by changes to policies or systems (such as compensation models, training, and experience), which could expand the availability of home visits and significantly enhance how Canadians experience death.
Reference: jpsmjournal.com/article/S0885-3924(22)00950-2/fulltext
