Table 1 Baseline Characteristics of 100,256 Community-living Ontarians with Dementia, by PCP’s daily patient volume
| Average Number of Patients Seen Daily by Patient’s Primary Care Physician | |||||
|---|---|---|---|---|---|
| < 20 | 20–24 | 25–29 | ≥ 30 |
Standardizessd Differencea
(< 20 vs ≥ 30) | |
| Patient Characteristics |
N = 36,150 (%) |
N = 21,362 (%) |
N = 15,224 (%) |
N = 27,520 (%) | |
| Age group | |||||
| 66–69 | 2,078 (5.7%) | 1,160 (5.4%) | 822 (5.4%) | 1,659 (6.0%) | 0.01 |
| 70–74 | 4,034 (11.2%) | 2,270 (10.6%) | 1,704 (11.2%) | 3,310 (12.0%) | 0.03 |
| 75–79 | 6,373 (17.6%) | 3,800 (17.8%) | 2,607 (17.1%) | 4,960 (18.0%) | 0.01 |
| 80–84 | 8,768 (24.3%) | 5,310 (24.9%) | 3,691 (24.2%) | 6,782 (24.6%) | 0.01 |
| 85 + | 14,897 (41.2%) | 8,822 (41.3%) | 6,400 (42.0%) | 10,809 (39.3%) | 0.04 |
| Sex | |||||
| Female | 21,794 (60.3%) | 12,598 (59.0%) | 8,779 (57.7%) | 15,822 (57.5%) | 0.06 |
| Male | 14,356 (39.7%) | 8,764 (41.0%) | 6,445 (42.3%) | 11,698 (42.5%) | 0.06 |
| Neighborhood Deprivation Index | |||||
| 1—least deprived | 6,422 (17.8%) | 3,554 (16.6%) | 2,480 (16.3%) | 3,396 (12.3%) | 0.15 |
| 2 | 7,104 (19.7%) | 3,994 (18.7%) | 2,822 (18.5%) | 4,332 (15.7%) | 0.10 |
| 3 | 7,065 (19.5%) | 4,186 (19.6%) | 2,868 (18.8%) | 4,946 (18.0%) | 0.04 |
| 4 | 7,296 (20.2%) | 4,295 (20.1%) | 3,154 (20.7%) | 6,442 (23.4%) | 0.08 |
| 5—most deprived | 7,431 (20.6%) | 4,886 (22.9%) | 3,538 (23.2%) | 7,618 (27.7%) | 0.17 |
| Missing data | 832 (2.3%) | 447 (2.1%) | 362 (2.4%) | 786 (2.9%) | 0.03 |
| Immigrated to Ontario in past 10 years | 561 (1.6%) | 346 (1.6%) | 278 (1.8%) | 753 (2.7%) | 0.08 |
| Location of dwelling | |||||
| Urban | 25,141 (69.5%) | 15,604 (73.0%) | 11,533 (75.8%) | 22,482 (81.7%) | 0.29 |
| Non-urban | 7,328 (20.3%) | 4,476 (21.0%) | 3,034 (19.9%) | 4,139 (15.0%) | 0.14 |
| Rural | 3,478 (9.6%) | 1,227 (5.7%) | 615 (4.0%) | 818 (3.0%) | 0.28 |
| Missing data | 203 (0.6%) | 55 (0.3%) | 42 (0.3%) | 81 (0.3%) | 0.04 |
| CIHI Comorbidity Group Index (2- year look-back) | |||||
| No health condition | 328 (0.9%) | 189 (0.9%) | 142 (0.9%) | 187 (0.7%) | 0.03 |
|
Major and palliative | 27,750 (76.8%) | 16,028 (75.0%) | 11,345 (74.5%) | 19,888 (72.3%) | 0.10 |
| Moderate | 5,193 (14.4%) | 3,356 (15.7%) | 2,387 (15.7%) | 4,741 (17.2%) | 0.08 |
| Minor | 2,570 (7.1%) | 1,564 (7.3%) | 1,130 (7.4%) | 2,226 (8.1%) | 0.04 |
| Non-user | 309 (0.9%) | 225 (1.1%) | 220 (1.4%) | 478 (1.7%) | 0.08 |
| Type of Dementia | |||||
| Alzheimer’s | 2,864 (7.9%) | 1,665 (7.8%) | 1,169 (7.7%) | 2,100 (7.6%) | 0.01 |
| Vascular | 786 (2.2%) | 474 (2.2%) | 309 (2.0%) | 580 (2.1%) | 0.00 |
| Other | 9,119 (25.2%) | 5,484 (25.7%) | 3,945 (25.9%) | 6,896 (25.1%) | 0.00 |
| Missing data | 23,381 (64.7%) | 13,739 (64.3%) | 9,801 (64.4%) | 17,944 (65.2%) | 0.01 |
| Years since dementia diagnosis | |||||
| 0–1 | 14,456 (40.0%) | 8,190 (38.3%) | 5,851 (38.4%) | 10,158 (36.9%) | 0.06 |
| 2–9 | 19,415 (53.7%) | 11,744 (55.0%) | 8,385 (55.1%) | 15,316 (55.7%) | 0.04 |
| ≥ 10 | 2,279 (6.3%) | 1,428 (6.7%) | 988 (6.5%) | 2,046 (7.4%) | 0.04 |
| # unique medications in use on index date | |||||
| 0–5 | 7,015 (19.4%) | 4,011 (18.8%) | 2,679 (17.6%) | 4,534 (16.5%) | 0.08 |
| 6–9 | 8,468 (23.4%) | 4,851 (22.7%) | 3,311 (21.7%) | 5,538 (20.1%) | 0.08 |
| 10–19 | 15,372 (42.5%) | 9,254 (43.3%) | 6,542 (43.0%) | 12,128 (44.1%) | 0.03 |
| 20 + | 5,295 (14.6%) | 3,246 (15.2%) | 2,692 (17.7%) | 5,320 (19.3%) | 0.12 |
| Medications taken in year prior to index date | |||||
|
Cholinesterase inhibitor | 14,942 (41.3%) | 9,265 (43.4%) | 6,729 (44.2%) | 12,112 (44.0%) | 0.05 |
| Benzodiazepine | 4,864 (13.5%) | 3,234 (15.1%) | 2,451 (16.1%) | 4,989 (18.1%) | 0.13 |
| Antipsychotic | 5,273 (14.6%) | 3,319 (15.5%) | 2,489 (16.3%) | 5,114 (18.6%) | 0.11 |
| Patient Rostering to PCP | |||||
| Not rostered | 1,728 (4.8%) | 750 (3.5%) | 759 (5.0%) | 2,061 (7.5%) | 0.11 |
| Rostered | 32,192 (89.1%) | 19,052 (89.2%) | 13,228 (86.9%) | 22,998 (83.6%) | 0.16 |
| Virtually rostered | 2,230 (6.2%) | 1,560 (7.3%) | 1,237 (8.1%) | 2,461 (8.9%) | 0.11 |
| Physicians seen in year prior to index date | |||||
| PCP | 31,059 (85.9%) | 18,732 (87.7%) | 13,053 (85.7%) | 23,645 (85.9%) | 0.00 |
|
Psychiatrist or geriatric psychiatrist | 4,013 (11.1%) | 2,055 (9.6%) | 1,444 (9.5%) | 2,617 (9.5%) | 0.05 |
| Geriatrician | 7,833 (21.7%) | 4,599 (21.5%) | 3,393 (22.3%) | 6,090 (22.1%) | 0.01 |
| Neurologist | 5,205 (14.4%) | 2,876 (13.5%) | 2,122 (13.9%) | 3,790 (13.8%) | 0.02 |
| Past-Year Hospitalizations or Emergency Department Visits | 16,655 (46.1%) | 9,567 (44.8%) | 6,920 (45.5%) | 12,377 (45.0%) | 0.02 |
| Doctor-Patient Relationship Variablesb | |||||
| • Annual number of visits to PCP | 8.24 ± 8.60 | 10.02 ± 9.96 | 10.84 ± 11.10 | 13.50 ± 15.03 | 0.43 |
|
• High annual PCP visit frequencyc | 6,181 (17.1%) | 5,109 (23.9%) | 4,183 (27.5%) | 9,847 (35.8%) | 0.21 |
| • Continuity of cared | 0.73 ± 0.33 | 0.78 ± 0.31 | 0.77 ± 0.32 | 0.76 ± 0.33 | 0.11 |
|
• High (≥ 0.75) continuity of care | 22,755 (62.9%) | 15,069 (70.5%) | 10,570 (69.4%) | 19,052 (69.2%) | 0.13 |
| • Relationship duratione | 8.20 ± 7.15 | 9.86 ± 7.42 | 10.00 ± 7.61 | 9.31 ± 7.38 | 0.15 |
|
• Same PCP for ≥ 5 years | 20,991 (58.1%) | 14,128 (66.1%) | 10,047 (66.0%) | 17,603 (64.0%) | 0.12 |