Regular doctor, changing doctor, no doctor: does it make a difference to rural residents?
BACKGROUND
In Canada, a larger proportion of rural residents than urban residents do not have a regular physician. In addition to lacking physicians, many rural communities also have a high rate of physician turnover. In order to discover the effect of this we compared health status, lifestyles, preventative care, and perceptions of the health system among rural residents with a regular doctor, those who did not have a regular doctor, and those whose regular doctor changed.


METHODS
We examined data from the 1995 Newfoundland Panel on Health and Medical Care and the 2001 Adult Health Survey. In each year, we compared these three groups of residents using chi2 tests and multiple logistic regression.


RESULTS
In 1995, 78.1% of rural residents had a regular doctor, 8.4% had changing doctors, and 13.5% did not have a regular doctor. In 2001, 84.6% of rural residents had a regular doctor, 4.9% had changing doctors, and 10.6% did not have a regular doctor. In 1995, compared with those with regular doctors, those whose doctors changed were less likely to have a disability or physical restriction, have their blood pressure checked or be satisfied with the healthcare system; while those without a regular physician were less likely to have poor health status, preventative care or be satisfied with the healthcare system. In 2001, there were no differences between those with a regular doctor and those whose doctor changed. Compared with those with a regular doctor, those without a regular doctor were less likely to have poor health status.


CONCLUSIONS
The proportion of rural residents who had a regular doctor increased between 1995 and 2001. Disparities between those who had a regular doctor and those with a frequently changing doctor diminished.
Mathews
M
M
Memorial University of Newfoundland, Health Science Centre, St. John's, NL, Canada. mmathews@mun.ca
Park
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D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009523:Newfoundland and Labrador / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012423:Rural Health / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors