After-hours care in Canada: Analysis of the 2001 National Family Physician Workforce Survey

OBJECTIVE To determine family physicians' availability to their general practice patients after hours and to explore the characteristics and determinants of after-hours services. DESIGN Secondary analysis of the 2001 National Family Physician Workforce Survey. SETTING Canada. PARTICIPANTS Canadian family physicians and general practitioners currently in practice (n = 10,553). MAIN OUTCOME MEASURES Provision of after-hours care, defined as providing care to all practice patients outside of normal office hours. RESULTS Sixty-two percent of Canadian family physicians reported providing after-hours service. The lowest rates were found in Quebec (34%) and the highest in Alberta and Saskatchewan (88%). Respondents practising in academic and community clinics, offering selective medical services (emergency care, palliative care, housecalls, after-hours care), or living outside of Ontario or Quebec were more likely to provide after-hours care. Women physicians, those practising in walk-in clinics, or physicians primarily paid by fee-for-service were less likely to do so. Urban versus rural location, organization of practice (solo or group), age of physician, country of graduation, and physician satisfaction were not found to significantly affect the likelihood of providing after-hours services. CONCLUSION Knowledge of these factors can be used to inform policy development for after-hours service arrangements, which is particularly relevant today, given provincial governments' interests in exploring alternative payment plans and primary care reform options.