Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada.
The Arthritis Program, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Am J Ophthalmol. 2019 Sep;205:184-196. doi: 10.1016/j.ajo.2019.04.006. Epub 2019 Apr 17.
To compare the effect of age, sex and generation on physician practice patterns in Ontario, Canada.
Retrospective cohort study.
Physician and patient data from 1992-2013 were used to calculate the yearly number of physicians, distinct patients seen, patient visits, government payments, physician age, sex, specialty, and year of birth. Age-period-cohort models were used for analysis.
There was a negligible change in the number of distinct patients for all physicians and family physicians and a 20.6% decrease for ophthalmologists. There were small declines in yearly visits for all physicians (14.2%) and family physicians (17.3%) and a 10.0% increase for ophthalmologists. There were a lower number of visits (and patients for ophthalmologists) in each succeeding recent birth cohort. For all groups and birth cohorts, male physicians had a significantly greater number of visits and patients. Median payments increased over time in all groups and were less for women with an average women-to-men ratio of 0.64 for all physicians, 0.75 for family physicians, and 0.59 for ophthalmologists. After adjusting for the number of visits and patients, sex differences in payments remained significant for all physicians and ophthalmologists but were no longer significant for family physicians.
Younger cohorts of Ontario physicians have greater yearly payments compared with older cohorts at the same age despite similar or a slightly lower number of visits and patients. The sex gap of payments was mostly explained by differences in the number of patients and visits for family physicians but remained significant for all physicians and ophthalmologists.
比较加拿大安大略省医生实践模式中年龄、性别和代际的影响。
回顾性队列研究。
使用 1992 年至 2013 年的医生和患者数据，计算每年医生人数、就诊患者人数、就诊次数、政府支付、医生年龄、性别、专业和出生年份。使用年龄-时期-队列模型进行分析。
所有医生和家庭医生的就诊患者人数几乎没有变化，眼科医生的就诊患者人数减少了 20.6%。所有医生（14.2%）和家庭医生（17.3%）的年就诊次数略有下降，而眼科医生的就诊次数增加了 10.0%。在每个较新的出生队列中，就诊次数（和眼科医生的就诊患者人数）都有所减少。对于所有组和出生队列，男性医生的就诊次数和患者人数明显更多。所有组的中位数支付都随着时间的推移而增加，女性的支付金额较低，所有医生的女性与男性比例平均为 0.64，家庭医生为 0.75，眼科医生为 0.59。在调整就诊次数和患者人数后，所有医生和眼科医生的支付性别差异仍然显著，但家庭医生的支付性别差异不再显著。
尽管就诊次数和患者人数相似或略低，安大略省较年轻的医生群体的年支付额仍高于年龄较大的医生群体。家庭医生支付性别差距主要是由于患者和就诊次数的差异，但对于所有医生和眼科医生来说，这种差距仍然显著。
