(P30) Examining the Link Between Physician Commitment and Care Quality

Introduction/Objective: Medical care of complex long-term care (LTC) residents is managed by physicians working in LTC. While physician commitment to LTC is thought to impact care quality, its influence on resident outcomes remains unclear. This study aimed to assess commitment among Ontario LTC physicians and its effect on resident care quality.

Design/Methodology : We conducted a retrospective cross-sectional study using Ontario health administrative databases for 2022. We describe a cohort of the most responsible physicians in LTC on their LTC and primary care practice, categorizing them by quintiles of commitment. We assessed conceptions of commitment like the proportion of LTC residents, years in LTC practice, and the number of LTC homes worked in. Regression models examined the relationship between continuous commitment and resident outcomes, including medication prescriptions, hospitalizations, transfers, and death.

Results: Our study identified 1368 LTC physicians in Ontario, each averaging 62 residents. These physicians were generally older, male, had less-than-full-time practices, and practiced in various settings beyond LTC. We observed limited associations between commitment metrics and resident outcomes, with some evidence suggesting higher commitment could be beneficial. Other factors beyond commitment appear to play a role in influencing care quality.

Conclusion/Discussion : Our work is the first to explore the impact of the Ontario LTC physician workforce on resident care quality. While commitment may be a factor, it is not the sole determinant of care quality. Further research is needed to refine how commitment is defined and measured, and to consider additional factors beyond the physician, such as infrastructure, LTC staff, and team collaboration.