Characteristics of patients who received a physician home visit in Ontario from Apr. 1, 2014, to Mar. 1, 2019
| Characteristic | No. (%) of patients* | SMD other v. palliative care† | SMD other v. home care† | |||
|---|---|---|---|---|---|---|
| Palliative care n = 78 463 | Home care n = 83 151 | Other n = 251 443 | Total n = 413 057 | |||
| Age, yr | ||||||
| < 18 | 843 (1.1) | 326 (0.4) | 52 828 (21.0) | 53 997 (13.1) | +0.67 | +0.71 |
| 18–39 | 1193 (1.5) | 987 (1.2) | 40 496 (16.1) | 42 676 (10.3) | +0.53 | +0.55 |
| 40–64 | 16 236 (20.7) | 7043 (8.5) | 52 172 (20.7) | 75 451 (18.3) | 0 | +0.35 |
| 65–79 | 28 224 (36.0) | 20 230 (24.3) | 41 640 (16.6) | 90 094 (21.8) | −0.45 | −0.19 |
| ≥ 80 | 31 967 (40.7) | 54 565 (65.6) | 64 307 (25.6) | 150 839 (36.5) | −0.33 | −0.88 |
| Female sex | 40 004 (51.0) | 52 076 (62.6) | 146 007 (58.1) | 238 087 (57.6) | +0.14 | −0.09 |
| Residence setting | ||||||
| Large urban | 51 490 (65.6) | 60 767 (73.1) | 211 026 (83.9) | 323 283 (78.3) | +0.43 | +0.27 |
| Small urban | 20 270 (25.8) | 15 550 (18.7) | 26 293 (10.5) | 62 113 (15.0) | −0.41 | −0.24 |
| Rural | 6011 (7.7) | 6202 (7.5) | 11 491 (4.6) | 23 704 (5.7) | −0.13 | −0.12 |
| Missing | 692 (0.9) | 632 (0.8) | 2633 (1.0) | 3957 (1.0) | +0.02 | +0.03 |
| Neighbourhood income quintile | ||||||
| 1 (lowest) | 17 135 (21.8) | 20 915 (25.2) | 60 541 (24.1) | 98 591 (23.9) | +0.05 | −0.02 |
| 2 | 16 399 (20.9) | 18 876 (22.7) | 50 484 (20.1) | 85 759 (20.8) | −0.02 | −0.06 |
| 3 | 15 433 (19.7) | 16 135 (19.4) | 44 461 (17.7) | 76 029 (18.4) | −0.05 | −0.04 |
| 4 | 14 304 (18.2) | 13 713 (16.5) | 41 730 (16.6) | 69 747 (16.9) | −0.04 | 0 |
| 5 (highest) | 14 978 (19.1) | 13 172 (15.8) | 52 670 (20.9) | 80 820 (19.6) | +0.05 | +0.13 |
| Missing | 214 (0.3) | 340 (0.4) | 1557 (0.6) | 2111 (0.5) | +0.05 | +0.03 |
| Limited proficiency in English or French | 2446 (3.1) | 2912 (3.5) | 11 330 (4.5) | 16 688 (4.0) | +0.07 | +0.05 |
| Immigrant | 5302 (6.8) | 6058 (7.3) | 29 739 (11.8) | 41 099 (9.9) | +0.18 | +0.15 |
| Comorbidity count | ||||||
| Low (≤ 5) | 7609 (9.7) | 10 488 (12.6) | 94 372 (37.5) | 112 469 (27.2) | +0.69 | +0.60 |
| Moderate (6–9) | 24 012 (30.6) | 24 624 (29.6) | 91 902 (36.5) | 140 538 (34.0) | +0.13 | +0.15 |
| High (≥ 10) | 46 842 (59.7) | 48 039 (57.8) | 65 169 (25.9) | 160 050 (38.7) | −0.73 | −0.68 |
| Comorbidities | ||||||
| Dementia | 12 423 (15.8) | 30 459 (36.6) | 25 997 (10.3) | 68 879 (16.7) | −0.16 | −0.65 |
| Mental health condition | 2958 (3.8) | 5595 (6.7) | 10 595 (4.2) | 19 148 (4.6) | +0.02 | −0.11 |
| Chronic obstructive pulmonary disease | 27 703 (35.3) | 29 027 (34.9) | 37 992 (15.1) | 94 722 (22.9) | −0.48 | −0.47 |
| Congestive heart failure | 17 514 (22.3) | 26 027 (34.9) | 21 582 (8.6) | 65 181 (15.8) | −0.39 | −0.59 |
| Asthma | 12 182 (15.5) | 15 872 (19.1) | 47 194 (18.8) | 75 248 (18.2) | +0.09 | −0.01 |
| Diabetes mellitus | 25 309 (32.3) | 32 666 (39.3) | 45 974 (18.3) | 103 949 (25.2) | −0.33 | −0.48 |
| Post partum or post birth | 101 (0.1) | 22 (0.0) | 3702 (1.5) | 3825 (0.9) | +0.15 | +0.17 |
| Resource Utilization Band | ||||||
| Low (≤ 2) | 795 (1.0) | 1403 (1.7) | 34 735 (13.8) | 36 933 (8.9) | +0.50 | +0.47 |
| Moderate (3) | 9682 (12.3) | 14 565 (17.5) | 112 603 (44.8) | 136 850 (33.1) | +0.77 | +0.62 |
| High (4–5) | 67 986 (86.6) | 67 183 (80.8) | 104 105 (41.4) | 239 274 (57.9) | −1.07 | −0.88 |
| No. of previous outpatient visits, median (IQR) | 29 (15–49) | 16 (8–27) | 8 (4–16) | 12 (5–24) | −1.24 | −0.63 |
| Emergency department visit in previous 30 d | 32 636 (41.6) | 22 904 (27.5) | 28 895 (11.5) | 84 435 (20.4) | −0.73 | −0.41 |
| Hospital discharge in previous 30 d | 29 114 (37.1) | 19 399 (23.3) | 15 120 (6.0) | 63 633 (15.4) | −0.82 | −0.50 |
| No. of home care visits in previous month | ||||||
| 0 | 17 246 (22.0) | 0 (0.0) | 244 219 (97.1) | 261 465 (63.3) | +2.38 | +8.22 |
| 1 | 4313 (5.5) | 0 (0.0) | 7224 (2.9) | 11 537 (2.8) | −0.13 | +0.24 |
| ≥ 2 | 56 904 (72.5) | 83 151 (100.0) | 0 (0.0) | 140 055 (33.9) | +2.30 | 0 |
| Primary care attachment | ||||||
| Formally enrolled | 62 981 (80.3) | 67 793 (81.5) | 176 863 (70.3) | 307 637 (74.5) | −0.23 | −0.26 |
| Other | 13 198 (16.8) | 14 068 (16.9) | 65 233 (25.9) | 92 499 (22.4) | +0.22 | +0.22 |
| No primary care physician visits | 2284 (2.9) | 1290 (1.6) | 9347 (3.7) | 12 921 (3.1) | +0.05 | +0.14 |
| Home visit physician was enrolling primary care physician | 19 186 (24.5) | 37 522 (45.1) | 62 722 (24.9) | 119 430 (28.9) | +0.01 | −0.43 |
| Home visit physician was in same group as enrolled primary care physician | 5285 (6.7) | 2674 (3.2) | 6441 (2.6) | 14 400 (3.5) | −0.20 | −0.04 |
| Home visit physician was same as enrolled primary care physician or in same group | 24 471 (31.2) | 40 196 (48.3) | 69 163 (27.5) | 133 830 (32.4) | −0.08 | −0.44 |
| Home visit physician was known to patient from visit in previous year | 41 281 (52.6) | 50 839 (61.1) | 97 002 (38.6) | 189 122 (45.8) | −0.28 | −0.46 |