The Relationship between Work Hours and Utilization of General Practitioners in Four Canadian Provinces

Abstract

Objective. To assess whether long work hours act as a barrier to accessing general practitioner (GP) services. Data Sources. Secondary data from the 1996/1997 National Population Health Survey (NPHS) and administrative health services utilization data from four Canadian provinces. Study Design. This study was cross-sectional, however, employment variables and GP utilization were reflective of the 12-month period preceding the NPHS interview date. Negative binomial regression was used to model the relationship between the number of GP visits in a 1-year period and employment-related variables while adjusting for other determinants of GP utilization including education, income, and health status. Data Extraction Methods. NPHS and administrative data were linked to create an analysis file. Principal Findings. Subjects with long, standard work hours (445 hours/week, with most hours during the day) had significantly lower GP utilization rates compared with full-time workers. White-collar workers with long work hours visited a GP significantly less often than white-collar workers with regular hours. Conclusions. Long work hours may act as a nonfinancial barrier to accessing GP services independent of health status.

Associations between Hours Worked, Symptoms and Health Resource Utilization among Full‐time Male Japanese Workers

“…Visiting a physician or CAM provider is time consuming in terms of such things as the time required to make the reservation and for travel, waiting and the consultation itself. Our results are consistent with those of a previous study that showed an inverse association between the number of hours worked and the number of physician visits 20) . With regard to OTC medication and dietary supplement use, given that most OTC medications are only available at pharmacies, whereas dietary supplements are available at supermarkets or over the Internet, longer working hours may act as a greater barrier to accessing OTC medication than dietary supplements.…”

“…We speculated that an increase in the number of hours worked may act as a barrier 20) to accessing certain (14) 52 (17) 21 (10) 37 (17) Throat pain/complaints 106 (14) 45 (14) 25 (12) 36 (17) Cough 93 (12) 42 (13) 22 (10) 29 (13) Acute upper respiratory inflammation 73 (10) 28 (9) 22 (10) 23 (11) (762 participants, full-time male Japanese workers, 2003) health resources and that certain resources would be preferred or avoided according to the number of hours worked. Visiting a physician or CAM provider is time consuming in terms of such things as the time required to make the reservation and for travel, waiting and the consultation itself.…”

Does time pressure create barriers for people to receive preventive health services?

“…A recent Japanese study found that men working long hours (N 250 per month) made about half as many physician visits as those working fewer (100-200) hours per month (Sato et al, 2011). A 2007 Canadian study found similar results indicating a statistically significant inverse association between patients' long work hours (N 45 h per week) and utilization of general practitioner services (Fell et al, 2007). These findings are consistent with a qualitative study in Canada, which found that work responsibilities and work time were the most commonly mentioned individual barriers to accessing primary care (Wellstood et al, 2006).…”

Favorable Ratings of Providers' Communication Behaviors Among U.S. Women with Depression: A Population-based Study Applying the Behavioral Model of Health Services Use

“…Working long hours may limit a woman’s ability to interact with the healthcare system (Fell et al, 2007; Witt et al, 2011), especially during regular office hours. According to a 2009 national survey, only 29% of U.S. primary care practices offered after-hours services whereby patients could see a provider in an non-emergent setting (Schoen et al, 2009).…”