Predictors of physician nursing home practice: does what we do in residency training make a difference?
OBJECTIVE
The number of physicians who care for nursing home patients is inadequate. This study determined predictors of current nursing home practice, including whether making nursing home rounds with an attending physician during residency is a predictor of subsequent nursing home practice.


METHODS
We used a cross-sectional survey to study 170 family physicians in private or academic practice in a large, university-based Midwestern family practice residency program.


RESULTS
The response rate was 86%. Fifty-five percent of respondents had an active nursing home practice. Rounding in a nursing home with an attending during residency had no relation to current nursing home practice. In comparison to physicians without an active nursing home practice, physicians with an active nursing home practice were more likely to reside in a smaller community, have a hospital practice (60.5% versus 39.5%), see more outpatients per week (105 versus 78), and work more hours per week (57 versus 49). In a logistic regression model, decreasing community size, number of hours worked per week, and having an active hospital practice were associated with active nursing home practice.


CONCLUSIONS
Factors other than educational experience have an effect on physician nursing home practice.
Gazewood
J D
JD
Department of Family Medicine, University of Virginia. jgazewood@virginia.edu
Mehr
D R
DR
D000046:Academic Medical Centers; D000328:Adult; D000553:Ambulatory Care; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000193:education*; D005544:Forecasting; D006801:Humans; D007325:Institutional Practice; D007396:Internship and Residency; D016015:Logistic Models; D008505:Medical Staff, Hospital; D008923:Missouri; D009735:Nursing Homes; D010820:Physicians; D011331:Private Practice; D011364:Professional Practice; D011365:Professional Practice Location; D018709:Statistics, Nonparametric; D013997:Time Factors