Effects of practice setting on GPs' provision of care.

OBJECTIVE To define a physician classification system based on practice settings and to analyze the service provision associated with those classifications. DESIGN A cross-sectional, retrospective study. SETTING Province of Quebec. PARTICIPANTS All GPs in Quebec in 2002 who had been practising for at least 2 years. MAIN OUTCOME MEASURES Practice setting variables were based on physician income in the different settings. Service provision was assessed using indicators related to continuity, comprehensiveness, accessibility, and productivity of services provided by the GPs. A multiple correspondence analysis with ascending hierarchical classification was conducted to construct the taxonomy of GPs based on their practice settings. RESULTS Our study produced 7 practice setting models. Two were essentially single-practice models. The 5 others combined several settings. Service provision varied from one model to another. Continuity was greater in the private practice model, in which older GPs were predominant, while accessibility was greater in multi-institutional practice models, in which younger GPs were more active. CONCLUSION To ensure balance between continuity, accessibility, and comprehensiveness in primary care services provided by GPs, it is important to consider the service provision associated with different practice models.