Office-based procedures among urban and rural family physicians in Ontario.
OBJECTIVE
To compare FP and GP performance of office-based procedures between urban and rural practices.


METHODS
Descriptive cohort study using health administrative data.


METHODS
Ontario.


METHODS
All FPs and GPs who billed the Ontario Health Insurance Plan for at least 1 office-based procedure between January 1 and December 31, 2006 (N = 8648).


METHODS
Ontario Health Insurance Plan billings for office-based procedures were adjusted by full-time equivalent (FTE) so that the means are for 1 FTE. Office-based procedures were grouped into 1) surgical procedures, 2) injections and immunizations, 3) electrocardiograms (ECGs), and 4) venipunctures and laboratory tests. The analyses were stratified for FP and GP age, sex, rurality of practice, and participation in a primary care model.


RESULTS
There were no substantial differences between FPs and GPs in rural practices compared with those in more urban practices with respect to surgical procedures. Rural FPs and GPs had lower mean numbers of injections and immunizations, ECGs, and venipunctures and laboratory tests than FPs and GPs practising in urban areas. Family physicians and GPs in primary care models had a lower mean number of surgical procedures but a higher adjusted mean number of injections and immunizations, ECGs, and venipunctures and laboratory tests.


CONCLUSIONS
For those procedures that are not dependent on specialist backup or access to more advanced technology, there were no substantial differences between rural and urban FPs and GPs. All comprehensive FPs and GPs should be able to provide these services to their patients. Training programs for all family medicine residents should ensure future FPs and GPs are able to perform these procedures.
Department of Family and Community Medicine, University of Toronto, 2075 Bayview Ave, G Wing, Toronto, ON M4N 3M5. liisa.jaakkimainen@ices.on.ca
R Liisa
RL
Jaakkimainen
Priya R
PR
Sood
Susan E
SE
Schultz
D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D015331:Cohort Studies; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000706:statistics & numerical data; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D007267:Injections / Q000706:statistics & numerical data; D007344:Insurance Claim Reporting / Q000145:classification / Q000706:statistics & numerical data; D009864:Ontario; D018962:Phlebotomy / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D019037:Urban Health Services / Q000706:statistics & numerical data*