What factors affect quality of care? Using the Peer Assessment Program in Ontario family practices

Abstract

Objective: To describe the relationship between the quality of care provided by family and general practitioners in Ontario and the demographics of the practitioners.

Design: Descriptive study using univariate and multivariate analysis to relate physician demographics to quality of care.

Setting: Ambulatory family and general practices in Ontario.

Participants: Each year from 1990 to 1994, all non-specialist physicians in Ontario reaching 70 years of age and a random sample of physicians younger than 70 who had been in practice more than 5 years were selected for assessment. After exclusion criteria were applied, the sample size was 922 physicians.

Main outcome measures: Grades assigned by the College of Physicians and Surgeons of Ontario's Peer Assessment Committee.

Results: Practices were assessed and graded by the Peer Assessment Committee. Grades were related to many variables, but many variables were correlated. Four variables remained significant at the P < .05 level. Younger physicians, female physicians, certificates of the College of Family Physicians of Canada, and urban physicians had, on average, higher grades.

Conclusion: Grades reflecting quality of care and record keeping were significantly associated with age, sex, certification status, and practice location. These findings should be examined and, for the benefit of patients, methods for improving care should be developed and explored.