Study of ambulatory physician utilization in St. John's, Newfoundland

Chard Kean, Loretta (2002) Study of ambulatory physician utilization in St. John's, Newfoundland. Masters thesis, Memorial University of Newfoundland.

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Abstract

The primary objective of this research was to study the demographic and socioeconomic factors thought to influence the type and level of ambulatory visits by individuals 20 years and older residing in St. John's, Newfoundland, Canada. The data were derived from the Newfoundland Panel on Health and Medical Care, a provincial study involving some 12,000 residents from which a sub-sample of 2861 adults residing in St. John's was analysed. The study combined a cross sectional survey with a longitudinal panel for physician utilization during 1992-95. -- A descriptive analysis of demographic variables (gender, age), socio-economic variables (education, income), and health status variables (self assessed health status and a number of chronic conditions) was conducted. Multivariate analysis was used to clarify the complex association between the selected variables and ambulatory physician utilization. Binary logistic regression techniques were first undertaken to predict the number of visits to both general practitioners and to specialists, and finally ordinal logistic regression was used to determine appropriate models for predicting the number of visits to general practitioners and specialists. -- Study results were consistent with findings in similar studies. Females are almost twice as likely to have a high number of visits to general practitioners than males, utilization increases with age, individuals with low socio-economic status (SES) scores, poor health status, and more than one chronic condition visited general practitioners more frequently. Although such patterns of utilization were found to be similar to those of specialists, some differences were noted. The study concludes that age, gender, income, education, health status, and the presence of chronic conditions were deemed to be good predictors of ambulatory physician utilization in the St. John's Institutional Board Region during the three year study period.

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