FACTORS ASSOCIATED WITH THE FREQUENCY OF HOUSE CALLS BY PRIMARY CARE PHYSICIANS

Objective: To evaluate factors associated with the frequency of house calls by primary care physicians. Design: A cross-sectional design with a self-administered mailed survey. Setting/participants: 751 primary care physicians who care for Medicaid patients in Virginia. Results: Among 389 physician respondents (52%), regular house callers (n = 216) were compared with occasional house callers (n = 162). Among physician characteristics, specialty and practice duration were associated with house call frequency. Regular house callers also more often cited chronic illness (67% vs. 20%, p < 0.01) and terminal illness (67% vs. 40%, p < 0.01) as indications for house calls, compared with occasional house callers. Use of visiting nurses to substitute for physician house calls was less often considered appropriate by frequent house callers (7% vs. 24%, p < 0.01), and regular house callers were less likely to report being "too busy" to make house calls (71% vs. 29%, p < 0.01). Multivariate analysis confirmed the association of these attitudes with house call frequency. Conclusion: These data suggest that specific attitudes among primary care physicians are associated with house call frequency.