'Rural' doesn't mean 'uniform': northern vs southern rural family physicians' workload and practice structures in Ontario.
'Rural' doesn't mean 'uniform': northern vs southern rural family physicians' workload and practice structures in Ontario.
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“农村”并不意味着“统一”：安大略省北部和南部农村家庭医生的工作量和执业结构。
DOI：
10.22605/rrh2720
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发表时间：
2014
影响因子：
2.1
通讯作者：
Nicole J Gauthier
中科院分区：
文献类型：
--
作者：
Elizabeth F. Wenghofer;P. Timony;Nicole J Gauthier
介绍
加拿大安大略的卫生政策倾向于将“北方”与“农村”混为一谈，并将北方农村环境与南方等同起来。虽然以前的研究已经确定了农村和城市从业者之间的一些差异，这些研究没有承认细微的差别，使农村的做法在北方比在南方不同。这项研究更密切地关注实践模式，并比较了北方农村、南方农村、北方城市和南方城市医生每周工作的小时数、病人数量和实践类型。
方法
这项研究利用了安大略医疗监管机构2007年年度会员更新调查的数据。描述性统计和χ（2）分析用于检查实践类型（如独奏，临床组），每周工作小时数和每周病人就诊人数为10 968初级保健医生在安大略的农村北部，农村南部，城市北部和城市南部。
结果
分析得出了三个关键结果：（1）安大略北方农村地区的医生每周工作时间比该省其他地区的医生更多，但（2）他们每周接诊的患者较少，（3）在基于临床小组的实践中工作更频繁。
结论
农村北方医生与不同的实践结构，不同的病人类型，更广泛的服务范围，不同的遭遇长度表明特定的位置和人群和社区的变化。农村和北方之间的相互作用是独特的，因此，对政策制定采取笼统的“农村”或“北方”办法可能是无效的。
INTRODUCTION
There is a tendency in health policy in Ontario, Canada, to conflate 'northern' with 'rural' and to equate northern rural settings with southern ones. Although previous research has identified some differences between rural and urban practitioners, these studies have not acknowledged the subtle nuances that make rural practice different in the north than in the south. This study looks more closely at practice patterns and compares number of hours worked per week, patient volume and practice type for rural northern, rural southern, urban northern and urban southern physicians.
METHODS
This study utilized data from Ontario's medical regulatory authority's 2007 annual membership renewal survey. Descriptive statistics and χ(2) analyses were used to examine practice type (eg solo, clinical group), hours worked per week and number of patient visits per week for 10 968 primary care physicians in Ontario's rural north, rural south, urban north and urban south.
RESULTS
Three key results emerged from the analyses: (1) physicians in rural northern Ontario worked more hours per week than their counterparts in other regions of the province, yet (2) they saw fewer patients per week, and (3) worked more frequently in clinical group-based practices.
CONCLUSIONS
Rural northern physicians with different practice structures, different patient types, broader scope of services, and different encounter lengths indicate variations specific to locations and populations and communities. The interaction between the rural and northern context is unique and as such a blanket 'rural' or 'northern' approach to policy development is likely to be ineffective.