Grant: Cat Gr:Policy Res. for Health Sys. Transf.- Canadian Healthcare Workforce

Despite the long-term care (LTC) sector (i.e., nursing homes) being thought of as one of the most-regulated and inspected healthcare sectors, care delivered by LTC doctors is seldom monitored. The COVID-19 pandemic has hit the LTC sector hard. Subsequent efforts in Ontario to address the observed deficiencies in care have focused on increased inspections and regulating the level of care provided by nursing staff, by personal support workers, and other allied workers. LTC doctors, however, have largely been forgotten, despite their important role in the care team. We will use rich, population-level "Big data" on all doctors practicing across LTC homes in Ontario, Canada. This evidence will be used inform policy options that may be used to regulate how the LTC physician workforce is organized and supported to optimize the LTC sector. Specifically, our 3 objectives are to: 1)Describe the LTC doctor workforce in Ontario. We will focus on factors that impact health human resources planning including: age, sex, specialty, years in practice, percentage of practice in LTC, and the health of doctors. 2)Understand the practice patterns of LTC doctors. At the home level: how many physicians are involved at any given time; what happens when a physician is away (e.g., on vacation, on leave, retires); how they provide 'call' coverage as evidenced by afterhours billings and billings on the weekend. 3)Evaluate outcomes: how characteristics of the LTC physician workforce (objective 1) and practice patterns (objective 2) are related to patient outcomes. Namely: emergency room visits, hospital admissions, deaths in hospitals, percentage of residents receiving palliative care prior to death.