UBC Theses and Dissertations
Factors influencing the life cycle activity patterns of fee-for-service physicians in British Columbia Kruger, Mary B.
Projection of the future supply of physician services has attracted considerable attention all over the world, especially in North America and Europe. Supply projections, however, have not taken into account physicians’ patterns of service provision. To date, no research on supply projections has examined the relative contribution to supply life-cycle activity patterns of physicians. This study examined the life-cycle activity patterns of two groups of non-postgraduate Directory Active fee-for-service physicians in British Columbia who had practised medicine for the period 1974-84 or 1980-84. Practice activity, the dependent variable, was measured by fee-adjusted payments made to individual physicians. Practice activity was conceptualized to be influenced by three groups of interrelated factors-- personal, professional, and environmental--each comprised of a number of distinct contributory variables. Data analyses included descriptive, logistical regression and time-series/ cross-section regression methods. The time-series/cross-section regression results showed that about 35% of the variance in practice activity could be explained by all variables except past practice activity. Including this variable in the regression equations increased the variances explained to about 90%. Specialty- and sex-specific analyses showed that variances explained by the three factors, and especially the variables comprising each of the factors, varied considerably. The personal factor accounted for most of the variances; the contributions of the professional factor were very small, while those of the environmental factor were negligible. A low previous year’s income emerged as the best predictor of self-declared retirement. Most GPs, medical, and surgical specialists retired long after the usual retirement age of 65 years. The practice activity of female GPs and medical specialists was significantly lower than those of their male counterparts; this observation did not apply to female surgical specialists. Sex-specific results showed that activity levels and patterns of childbearing-aged females did not differ significantly from their non-childbearing aged counterparts. The research provides comprehensive data on the major variables influencing physician activity in a setting with comprehensive, universal, first dollar health care insurance. It also offers many insights for those interested in policy respecting physician supply and requirements, physician retirement patterns, and sex- and specialty-specific differences in practice patterns.
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