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The home care practice and attitudes of Minnesota family physicians
J M Keenan1, C J Bland, L Webster
1University of Minnesota Medical School, Department of Family Practice and Community Health, Minneapolis.
Objective:
Assess home care practice and attitudes of Minnesota family physicians (FPs).
Design:
Mailed survey.
Setting:
State of Minnesota.
Participants:
Members of the Minnesota Academy of Family Physicians, 80% of the FPs practicing in the state.
Intervention:
A 55-item mailed, self-complete questionnaire regarding general practice and personal physician characteristics (18 questions), specific questions regarding geriatric and home care practice and related attitudes (37 questions); up to four reminder or follow-up surveys were sent.
Main Outcome Measures:
Descriptive summary of FP home care practice and attitudes.
Results:
Eighty percent of surveys were completed, 76% of responding physicians made at least one home visit in the previous year, and 92% of home visits were to geriatric patients. Discriminant function analysis identified six significant (P less than 0.001) variables that explained 52% of the variance (r2 = 0.52, Wilks Lambda = 0.48) in home visiting behavior between frequent home visiting FPs (greater than 24 visits/year) and non-visiting FPs. FPs most likely to do home visiting were older and tended to have small group or solo practices in rural settings.
Conclusion:
The survey documented continued decline (from previously published surveys) of physician home visiting behavior and widespread dissatisfaction with reimbursement. However, attitudes regarding home care provided by other professionals were highly positive.