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Demographic and practice characteristics of family physicians practicing palliative care
One critical aspect of palliative care delivery is the provision of palliative care by primary care physicians. We identified demographic and practice characteristics of family physicians who report they provide palliative care.
Methods
We used the 2013 (N=10, 887) American Board of Family Medicine (ABFM) diplomate re-certification survey to assess self-reported types and sites of care, including palliative care, pain management, hospice, nursing home, and home visits as measure of palliative care provision. For these categories, we used logistic regression models to predict the factors associated with the likelihood of family physicians providing these services.
Results
Thirty percent report they provide palliative care and 45% pain management; 23% see patients in nursing homes, 15% in patients’ homes and 7% in hospices. Physicians who report caring for patients in alternative settings were more likely to be male, white, longer in practice, rural, and practice in either certified Patient Centered Medical Home (PCMH) or applicants for PCMH certification.
Policy Implications
A small but significant number of family physicians engage in palliative care. However, it is concerning that physicians newer to practice have lower rates of engaging in these services as this may indicate a trend. It is possible that the structure of PCMHs and rural environments are more supportive of physicians engaging in palliative care, suggesting need for improvements in education and infrastructure.
Learning Areas:
Biostatistics, economicsChronic disease management and prevention
Epidemiology
Public health or related public policy
Learning Objectives:
Describe the demographics and associated practice settings of family physicians who provide palliative care in the context of changing patient preferences, demographics and population need for palliative care services.
Keyword(s): Patient-Centered Care
Qualified on the content I am responsible for because: My work is focused on secondary data analysis of large databases (CMS, MEPS, NHIS) to assess the physician workforce, access, utilization and outcomes. I am particularly interested in the role of family physicians in palliative care, family physician workforce and primary care for with people with disabilities using the American Board of Family Medicine database.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.