The relationship between work hours and utilization of general practitioners in four Canadian provinces

Abstract

Objective: To assess whether long work hours act as a barrier to accessing general practitioner (GP) services.

Data sources: Secondary data from the 1996/1997 National Population Health Survey (NPHS) and administrative health services utilization data from four Canadian provinces.

Study design: This study was cross-sectional, however, employment variables and GP utilization were reflective of the 12-month period preceding the NPHS interview date. Negative binomial regression was used to model the relationship between the number of GP visits in a 1-year period and employment-related variables while adjusting for other determinants of GP utilization including education, income, and health status.

Data extraction methods: NPHS and administrative data were linked to create an analysis file.

Principal findings: Subjects with long, standard work hours (>45 hours/week, with most hours during the day) had significantly lower GP utilization rates compared with full-time workers. White-collar workers with long work hours visited a GP significantly less often than white-collar workers with regular hours.

Conclusions: Long work hours may act as a nonfinancial barrier to accessing GP services independent of health status.