A Cross-Sectional Study of Factors Associated With Pediatric Scope of Care in Family Medicine

Abstract

Purpose: The objective of this study was to identify demographic and practice characteristics associated with family physicians' provision of care to children including a subgroup analysis of those who see pediatric patients younger or older than 5 years of age.

Methods: This cross-sectional study used data from US family physicians taking the American Board of Family Medicine continuous certification examination registration questionnaire in 2017 and 2018. The outcome of interest was self-reported care of pediatric patients in practice. We performed bivariate and multivariate logistic regression examining the association between various demographic and practice characteristics with the outcome of interest. We performed subgroup analyses for physicians seeing patients under 5 years old and from 5 to 18 years old.

Results: Among the 11,674 family physicians included in the final analysis, 9744 (83.8%) saw pediatric patients. Physician- and practice-level factors associated with seeing pediatric patients included rural practice, younger age, non-Hispanic White race/ethnicity, independent practice ownership, nonsolo practice, lower pediatrician density, and higher income geographic area. More family physicians saw 5-to-18-year-olds than < 5-year-olds (83.6% vs 68.2%; P < .001), and the factors associated with pediatric care were similar among these age subgroups.

Conclusions: A majority of continuous certification US family physicians see pediatric patients in practice; however, rates of pediatric care vary widely based on various demographic and practice characteristics. Efforts to maintain a broad scope of practice for US family physicians will require exploration of the underlying mechanisms driving these practice patterns.

Keywords: Behavioral Medicine; Child Health; Cross-Sectional Studies; Family Medicine; Family Physicians; Logistic Models; Primary Care Physicians; Social Determinants of Health.