Predictors of physician nursing home practice: does what we do in residency training make a difference?

BACKGROUND AND OBJECTIVES: The number of physicians who care for nursing home patients is inadequate. This study determined predictors of current nursing home practice, including whether making nursing home rounds with an attending physician during residency is a predictor of subsequent nursing home practice.
METHODS: We used a cross-sectional survey to study 170 family physicians in private or academic practice in a large, university-based Midwestern family practice residency program.
RESULTS: The response rate was 86%. Fifty-five percent of respondents had an active nursing home practice. Rounding in a nursing home with an attending during residency had no relation to current nursing home practice. In comparison to physicians without an active nursing home practice, physicians with an active nursing home practice were more likely to reside in a smaller community, have a hospital practice (60.5% versus 39.5%), see more outpatients per week (105 versus 78), and work more hours per week (57 versus 49). In a logistic regression model, decreasing community size, number of hours worked per week, and having an active hospital practice were associated with active nursing home practice.
CONCLUSIONS: Factors other than educational experience have an effect on physician nursing home practice.