• Melissa K Andrew, Frederick Burge, and Emily Gard Marshall.
• Associate Professor of Medicine in the Division of Geriatric Medicine, Dalhousie University in Halifax, NS. mandrew@dal.ca.
• Can Fam Physician. 2020 Apr 1; 66 (4): 275-280.

ObjectiveTo examine how FP and practice characteristics relate to the provision of home visits.DesignCensus survey linked to administrative billing data.SettingNova Scotia, 2014 to 2015.ParticipantsRespondents to the family physician practice survey (N = 740; 84.5% response rate), the FP provider survey (N = 677; 56.7% response rate), and the nurse practitioner provider survey (N = 45; 68.9% response rate).Main Outcome MeasuresProvision of home visits. Family physician characteristics included age, sex, and proximity to retirement; practice characteristics included patient age and practice rurality.ResultsOverall, 84.4% of surveyed FPs reported that they did home visits. In both survey data and billing data, older FPs were more likely to do home visits (P < .01). In multivariate analyses, older FP age, older patient age, rural practice location, and male FP sex were all independently associated with provision of any home visits and with the number of home visits (all P < .0001). Among FPs who had billed for home visits in the study year, the median (interquartile range [IQR]) number of visits was 16 (2 to 42); the range was 1 to 1265. Male FPs billed for more home visits (median [IQR] = 21 [7 to 54] visits) than female FPs (median [IQR] = 12 [4 to 30]) did (P < .001). Rural FPs had performed more home visits (median [IQR] = 29 [8 to 83]) than their urban counterparts (median [IQR] = 14 [5 to 36]) had (P < .001).ConclusionMost FPs in Nova Scotia who responded to our survey reported doing home visits. This is an encouraging finding for the care of vulnerable older adults and runs counter to the widely held view that home visits are a dying art. Nevertheless, given that older male FPs are more likely to do home visits, there could be work force implications as these FPs retire. As the population ages, strategies to support home visits will be an important area for further research and policy development.Copyright© the College of Family Physicians of Canada.

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