Engagement of Primary Care Physicians in Home Palliative Care

J Palliat Care. 2017 Jan;32(1):3-10. doi: 10.1177/0825859717706791.

Abstract

Purpose: To describe prevalence and characteristics associated with family physician and general practitioner (FP/GP) provision of home palliative care (HPC).

Methods: We surveyed FP/GPs in an urban health region of Ontario, Canada, to determine their current involvement in HPC, the nature of services provided, and perceived barriers and enablers.

Results: A total of 1439 surveys were mailed. Of the 302 FP/GP respondents, 295 provided replies regarding engagement in HPC: 101 of 295 (33%) provided HPC, 76 (26%) were engageable with further support, and 118 (40%) were not engageable regardless of support. The most substantial barrier was time to provide home visits (81%). Engaged FP/GPs were most likely to be working with another physician providing HPC ( P < .0001). Engageable FP/GPs were younger ( P = .007) and placed greater value on improved remuneration ( P < .001) than the other groups. Nonengageable physicians were most likely to view time as a barrier ( P < .0001) and to lack interest in PC ( P = .03).

Conclusion: One-third of FP/GPs provide HPC. A cohort of younger physicians could be engageable with adequate support. Integrated practices including collaboration with specialist PC colleagues should be encouraged and supported.

Keywords: family physician; general practitioner; home palliative care; palliative care; primary care; survey.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel*
  • Female
  • Home Care Services / organization & administration*
  • Humans
  • Male
  • Middle Aged
  • Ontario
  • Palliative Care / organization & administration*
  • Physicians, Primary Care / psychology*
  • Primary Health Care / organization & administration*
  • Professional Role
  • Surveys and Questionnaires