Characteristics of physicians, practice patterns and patient characteristics for the high-volume home visit physicians (top 5%) compared with low-volume home visit physicians (Jan. 1–Dec. 31, 2019)
| Characteristic | High-volume home visit physicians n = 330 | Low-volume home visit physicians n = 6242 | SMD* |
|---|---|---|---|
| Physician characteristics | |||
| Physician age, yr, median (IQR) | 51 (38.0–61.0) | 50 (38.0–60.0) | 0.04 |
| Self-reported physician gender, female, no. (%) | 121 (36.7) | 2887 (46.3) | 0.20 |
| Canada medical graduate, no. (%)† | |||
| Yes | 196 (59.4) | 3768 (60.4) | 0.02 |
| Missing | 61 (18.5) | 1228 (19.7) | 0.03 |
| Physician urban or rural practice, no. (%)‡ | |||
| Large urban | 181 (54.8) | 2689 (43.1) | 0.24 |
| Medium urban | 89 (27.0) | 1606 (25.7) | 0.03 |
| Small urban | 49 (14.8) | 1299 (20.8) | 0.16 |
| Rural | 10 (3.0) | 616 (9.9) | 0.28 |
| Missing | 33 (0.5)** | – | |
| Physician medical home enrolment, no. (%) | 213 (64.5) | 5301 (84.9) | 0.48 |
| Physician compensation model, no. (%) | |||
| Capitation | 45 (13.6) | 1370 (21.9) | 0.22 |
| Team based | ≥ 35 (≥ 10.6)** | 1950 (31.2) | 0.50 |
| Enhanced fee for service | 127 (38.5) | 1924 (30.8) | 0.16 |
| Fee for service | 117 (35.5) | 941 (15.1) | 0.48 |
| Other | 60 (0.9)** | 0 | |
| Physician-level home visit volumes and payment, median (IQR) | |||
| No. of home visits | 477.5 (346.0–813.0) | 9 (2.0–28.0) | 2.58 |
| No. of unique home visit patients seen | 126 (79.0–240.0) | 5 (2.0–12.0) | 2.50 |
| Patients seen per day on a day doing home visits | 3 (2.0–5.5) | 1 (1–1) | 3.09 |
| No. of home visits per patient | 4.1 (2.4–6.4) | 1.6 (1–2.5) | 1.20 |
| Home visits income (% total billing) | 31.5 (16.6–51.6) | 0.9 (0.2–3.4) | 2.22 |
| Home visits that are off-hours, %§ | 17.9 (3.8–84.5) | 16.7 (0–66.7) | 0.27 |
| Physician-level home visit patient characteristics | |||
| Median patient age, yr, no. (%) | |||
| < 18 | 110 (1.7)** | 0.13 | |
| 18–39 | 199 (3.0)** | 0.13 | |
| 40–64 | 42 (12.7) | 696 (11.2) | 0.05 |
| 65–79 | 115 (34.8) | 1637 (26.2) | 0.19 |
| ≥ 80 | 157 (47.6) | 3616 (57.9) | 0.21 |
| Patients aged ≥ 65 yr, %, median (IQR) | 82.4 (61.6–95.1) | 96.3 (70–100) | 0.66 |
| Median patient health care resource utilization band, no. (%) | |||
| Low (0–2) | 0 | 122 (2.0) | 0.20 |
| Moderate (3) | 38 (11.5) | 1109 (17.8) | 0.18 |
| High (4–5) | 292 (88.5) | 5011 (80.3) | 0.23 |
| Patients in a lower-income neighbourhood, %, median (IQR) | 46.4 (30.7–57.1) | 37.5 (3.8–71.4) | 0.23 |
| Patients in a large urban area, %, median (IQR) | 66.4 (1.9–97.2) | 6.3 (0–100.0) | 0.29 |
| Recent immigrant patients, %, median (IQR)¶ | 0.2 (0–2.0) | 0 (0) | 1.19 |
| Home visits made to patients who are enrolled to them personally, %, median (IQR) | 0.3 (0–50.1) | 75 (0–100.0) | 0.93 |
| Home visits made to their own or to their group’s enrolled patients, %, median (IQR) | 4 (0–56.3) | 87.5 (28.6–100.0) | 1.12 |
| Patients previously known in the prior 2 years, %, median (IQR) | 72.3 (34.1–94.0) | 100 (80.0–100.0) | 1.13 |
| Patients not in a medical home, %, median (IQR) | 27 (18.8–41.1) | 2.2 (0–29.8) | 1.03 |
| Home visits made to patients who received ≥ 2 home care visits in the previous 30 days, %, median (IQR) | 53.9 (32.1–82.0) | 60 (28.1–87.1) | 0.08 |
| Home visits that were palliative, %, median (IQR) | 7.1 (0–95.8) | 3.8 (0–50.0) | 0.30 |
| Home visits that were neither home care nor palliative, %, median (IQR) | 42.6 (1.2–66.6) | 29.4 (0–61.5) | 0.10 |
Note: IQR = interquartile range, SMD = standardized mean difference.
↵* Standardized mean differences greater than or equal to 10% (0.1) are considered meaningful.
↵† Data from before 2014 are pulled forward where possible; however, this variable is not available for physicians who joined the College of Physicians and Surgeons of Ontario after 2014 (~25% missing in this data set).
↵‡ Rurality Index for Ontario score cut-offs were as follows: 0 large urban, 1–9 medium urban, 10–39 small urban and ≥ 40 rural.
↵§ ”Off-hours” was defined as a visit occurring between 5 pm and 7 am on weekdays or anytime on Saturday or Sunday and public holidays.
↵¶ ”Recent” was defined as within the past 10 years.
↵** Cells adjusted or combined to prevent reidentification of groups of < 6 individuals.