Where do children go? Comparing the after-hours availability of family physicians and primary care pediatricians in four Canadian cities.
OBJECTIVE
To describe and compare family physicians' and pediatricians' after-hours availability for pediatric care in four Canadian cities.


METHODS
Cross-sectional telephone survey.


METHODS
Winnipeg, Toronto, Ottawa, and Montreal pediatric and family practices.


METHODS
All primary care pediatricians and an equal number of family physicians randomly selected from the membership list of the College of Family Physicians of Canada were matched by postal code. Sixty-four (10%) of 282 family physicians and 296 primary care pediatricians were excluded, most because no office telephone number was found.


METHODS
"After hours" was defined as between 1800 and 0700 hours on weekdays and 0900 to 2400 hours on weekend days. Outcomes included demographics, year of graduation, day of call, time of call, and availability of physician.


RESULTS
Availability varied markedly by city rather than by physicians were available after hours: 92.4% in Winnipeg, 56.0% in Toronto, 65.5% in Ottawa, and 26.9% in Montreal. Winnipeg, Toronto, and Montreal showed no significant differences between specialties in availability. Only Ottawa pediatricians were significantly more available than family physicians when age was taken into account (adjusted relative risk = 2.17, 95% confidence interval = 1.51 to 3.12). Stratified analysis showed no differences by day of call, time of call, or physicians' sex. Physicians graduating before 1975 in both groups tended to be more available in all cities than younger physicians.


CONCLUSIONS
Regional differences appear to influence after-hours availability more than specialty. Older physicians from both groups were more available than younger physicians.
Patel
H
H
Intensive Ambulatory Care Service, Montreal Children's Hospital.
Macarthur
C
C
Feldman
W
W
D002648:Child; D002662:Child Health Services; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008350:Manitoba; D009864:Ontario; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D011792:Quebec; D000078329:Workforce