Physician Utilization

1

Physician Utilization
2
Proportion of women () receiving prenatal care,
by physician type, 2003/04
By Local Health Integration Network (LHIN) and
for Ontario
No billings
All Ontario
Visits shared between GP/FP OB
14. North West
10. South East
75 of visits to OB
12. North Simcoe Muskoka
75 of visits to GP/FP
13. North East

• This includes women whose physician did not
  bill the Ontario Health Insurance Plan (OHIP),
  those who were seen predominantly by midwives or
  nurse practitioners and those who received little
  or no prenatal care (lt4 visits).
• Some women receive the majority of their
  prenatal care (75 of their OHIP visits) from
  GP/FPs while others receive the majority of their
  care (75 of their OHIP visits) from OBs. In
  other women, prenatal care is shared more
  evenly between OBs and GP/FPs.
• GP/FP General practitioner/family physician
• OB Obstetrician

2. South West
5. Central West
11. Champlain
9. Central East
4. Hamilton Niagara Haldimand Brant
6. Mississauga Halton
7. Toronto Central
3. Waterloo Wellington
8. Central
1. Erie St. Clair
0 20 40
60 80 100
Proportion of women ()
The profile of physicians who provided
prenatal care to women in Ontario varied by
LHIN. In the North West, South East, North
Simcoe Muskoka and North East LHINs, there were
large proportions of women who received at least
75 of their prenatal care from GP/FPs.
3
Proportion of physician-attended deliveries (),
by provider type, 2003/04
By Local Health Integration Network (LHIN) and
for Ontario
All Ontario
8. Central
1. Erie St. Clair
5. Central West
9. Central East
7. Toronto Central

• Both GP/FP and OB listed as attending
  physician on the hospital record.
• Includes midwives and physicians other than
  GP/FP and OB.
• GP/FP General practitioner/family physician
• OB Obstetrician

6. Mississauga Halton
3. Waterloo Wellington
11. Champlain
10. South East
4. Hamilton Niagara Haldimand Brant
2. South West
13. North East
12. North Simcoe Muskoka
14. North West
0 20 40
60 80
100
Proportion of physician-attended deliveries ()
Obstetricians performed the vast majority of
deliveries in Ontario in 2003/04. The greatest
proportion of deliveries attended by general
practitioners/family physicians occurred among
women in the North West (39), North East (23)
and North Simcoe Muskoka (22) LHINs.
4
Number and percentage of midwife-assisted births
as a percentage of all births, 2003/04
By Local Health Integration Network (LHIN) and
for Ontario

• This includes patients not assigned to a LHIN.

The largest proportion of midwife-assisted
births (as a proportion of all births) occurred
in the North West (20), North Simcoe Muskoka
(16) and North East (10) LHINs. The largest
number of midwife-assisted births occurred in the
Toronto Central, Hamilton Niagara Haldimand Brant
and Waterloo Wellington LHINs.
5
Number of paediatrician visits per year, and
percentage who visited a paediatrician, for all
children aged 017 years, 2002/032003/04
By Local Health Integration Network (LHIN) in
Ontario
Percentage of children
Average number of visits
Age refers to the childs age at the beginning
of the two-year period.
There was marked variation by LHIN in the
proportion of children who accessed care from
paediatricians. This included primary care as
well as other kinds of ambulatory care (e.g.,
referral from a general practitioner/family
physician for consultation). There was also
marked variation by LHIN in the average number of
visits made to paediatricians by children who
were seeking their services.
6
Number of paediatrician visits per year and
percentage who visited a paediatrician, for low
birthweight children aged 017 years,
2002/032003/04
By Local Health Integration Network (LHIN) in
Ontario
Percentage of children
Average number of visits
Age refers to the childs age at the beginning
of the two-year period. Low birthweight
children are those who weighed less than 2,500
grams at birth.
There was marked variation by LHIN in the
proportion of low birthweight children who
accessed care from paediatricians. This included
primary care as well as other kinds of ambulatory
care (e.g., referral from a general
practitioner/family physician for
consultation). There was also marked variation
by LHIN in the average number of visits made to
paediatricians by children who were seeking
their services.
7
Number of paediatrician visits per year, and
percentage who visited a paediatrician, for
children with asthma aged 017 years,
2002/032003/04
By Local Health Integration Network (LHIN) in
Ontario
Percentage of children
Average number of visits
Age refers to the childs age at the beginning
of the two-year period.
There was marked variation by LHIN in the
proportion of children with asthma who accessed
care from paediatricians. This included primary
care as well as other kinds of ambulatory care
(e.g., referral from a general practitioner/famil
y physician for consultation). There was also
marked variation by LHIN in the average number of
visits made to paediatricians by children who
were seeking their services.
8
Number of paediatrician visits per year, and
percentage who visited a paediatrician, for
children with complex chronic conditions aged
017 years, 2002/032003/04
By Local Health Integration Network (LHIN) in
Ontario
Percentage of children
Average number of visits
Age refers to the childs age at the beginning
of the two-year period. Complex chronic
conditions include cerebral palsy, cystic
fibrosis, etc.
There was marked variation by LHIN in the
proportion of children with complex chronic
conditions who accessed care from
paediatricians. This included primary care as
well as other kinds of ambulatory care (e.g.,
referral from a general practitioner/family
physician for consultation). There was also
marked variation by LHIN in the average number of
visits made to paediatricians by children who
were seeking their services.
9
Number of physician office visits per year for
adults (2064 years), by physician specialty
type, 2002/03
By Local Health Integration Network (LHIN) in
Ontario
GP/FP General practitioner/family physician
GIM General internal medicine specialist OBGYN
Obstetrician/gynecologist Specialist comprises
all specialists including GIMs, OBGYNs,
geriatricians and consultant specialists.
In adults (20-64 years), there was little
variation in physician office visit rates by
LHIN.
10
Number of physician office visits per year for
older adults (65 years and older), by physician
specialty type, 2002/03
By Local Health Integration Network (LHIN) in
Ontario
GP/FP General practitioner/family physician
GIM General internal medicine specialist OBGYN
Obstetrician/gynecologist Specialist comprises
all specialists including GIMs, OBGYNs,
geriatricians and consultant specialists.
There were small variations in physician
office visits rates by LHIN in older adults (65
years and older).
11
Proportion of adults () aged 2064 years seen
for office-based care,by physician specialty
type, 2002/03
By Local Health Integration Network (LHIN) in
Ontario
GP/FP only
10. South East
GP/FP GIM/OBGYN
12. North Simcoe Muskoka
5. Central West
GP/FP specialists
2. South West
9. Central East
Specialist only
14. North West
No physicianvisit billings
6. Mississauga Halton
13. North East
GP/FP General practitioner/family physician GIM
General internal medicine specialist OBGYN
Obstetrician/ gynecologist Specialist comprises
all specialists including GIMs, OBGYNs and
geriatricians.
1. Erie St. Clair
3. Waterloo Wellington
8. Central
11. Champlain
4. Hamilton Niagara Haldimand Brant
7. Toronto Central
0 20 40
60 80
100
Proportion of adults ()
For both younger and older adults, the LHINs
with the lowest proportion of GP/FP only care
also had the highest proportion of GP/FP plus
specialist care. Compared with older adults,
young adults (2064 years) had higher proportions
of no physician visit billings for all LHINs.
12
Proportion of adults () aged 65 years and older
seen for office-based care,by physician
specialty type, 2002/03
By Local Health Integration Network (LHIN) in
Ontario
GP/FP only
10. South East
GP/FP GIM/geriatrician
2. South West
14. North West
GP/FP specialists
13. North East
3. Waterloo Wellington
Specialist only
12. North Simcoe Muskoka
No physicianvisit billings
5. Central West
1. Erie St. Clair
GP/FP General practitioner/family physician GIM
General internal medicine specialist OBGYN
Obstetrician/ gynecologist Specialist comprises
all specialists including GIMs, OBGYNs and
geriatricians.
9. Central East
6. Mississauga Halton
4. Hamilton Niagara Haldimand Brant
8. Central
7. Toronto Central
11. Champlain
0 20 40
60 80
100
Proportion of adults ()
For both younger and older adults, the LHINs
with the lowest proportion of GP/FP only care
also had the highest proportion of GP/FP plus
specialist care. Compared with older adults,
young adults (2064 years) had higher proportions
of no physician visit billings for all LHINs.
13
Proportion of physician visits () in the
post-treatment period in patientsdiagnosed with
all cancers combined, between April 1, 1993
and March 31, 2002, by physician type
By Local Health Integration Network (LHIN) in
Ontario
10. South East
GP/FP
2. South West
Oncology
12. North Simcoe Muskoka
Other
13. North East
9. Central East

• Two-year time period starting one year after
  date of diagnosis.
• Lung, colorectal, breast and prostate cancer.
• GP/FP General practitioner/family physician

5. Central West
11. Champlain
8. Central
6. Mississauga Halton
3. Waterloo Wellington
1. Erie St. Clair
7. Toronto Central
14. North West
4. Hamilton Niagara Haldimand Brant
0 20 40
60 80
100
Proportion of physician visits ()

• There was some variation across LHINs in the
  follow-up care of cancer patients (lung,
  colorectal, breast and prostate cancers
  combined) by GP/FPs and by oncologists.
• The highest proportion of visits to oncologists
  was in the North West (29), Central West (28)
  and Hamilton Niagara Haldimand Brant (27) LHINs.

14
Proportion of physician visits () in the
palliative period in patients diagnosed with
all cancers combined, between April 1, 1993 and
March 31, 2002, and who died before March 31,
2005, by physician type
By Local Health Integration Network (LHIN) in
Ontario
10. South East
GP/FP
2. South West
Oncology
12. North Simcoe Muskoka
Other
11. Champlain
3. Waterloo Wellington
9. Central East
13. North East

• Final three months of life ending with date of
  death.
• Lung, colorectal, breast and prostate cancer.
• GP/FP General practitioner/family physician

14. North West
4. Hamilton Niagara Haldimand Brant
1. Erie St. Clair
7. Toronto Central
8. Central
6. Mississauga Halton
5. Central West
0 20 40
60 80
100
Proportion of physician visits ()

• There was some variation across LHINs in the
  palliative care of cancer patients by GP/FPs and
  by oncology specialists, when lung, colorectal,
  breast and prostate cancers were combined. 
• The highest proportion of visits to oncologists
  was in the Central West (38), Mississauga Halton
  (32) and Hamilton Niagara Haldimand Brant (31)
  LHINs.