Primary care physicians working in rural areas provide a broader scope of practice: a cross-sectional study
Abstract Background Scope of practice (SoP) is an important factor for primary care physicians (PCPs). One of the strong determinants of SoP is rurality. Although Japan has several rural areas, the SoP in rural areas and the effect of rurality on SoP have not been investigated. This study aimed to d...
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Language: | English |
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BMC
2024-01-01
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Series: | BMC Primary Care |
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Online Access: | https://doi.org/10.1186/s12875-023-02250-y |
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author | Makoto Kaneko Tomoya Higuchi Ryuichi Ohta |
author_facet | Makoto Kaneko Tomoya Higuchi Ryuichi Ohta |
author_sort | Makoto Kaneko |
collection | DOAJ |
description | Abstract Background Scope of practice (SoP) is an important factor for primary care physicians (PCPs). One of the strong determinants of SoP is rurality. Although Japan has several rural areas, the SoP in rural areas and the effect of rurality on SoP have not been investigated. This study aimed to describe SoP in Japanese primary care settings and examine the association between rurality and SoP. Methods This cross-sectional study included PCPs in Japan. The participants were randomly sampled from the mailing list of the Japan Primary Care Association. The Scope of Practice Inventory (SPI) and Scope of Practice for Primary Care (SP4PC) were used as indicators of SoP. The Rurality Index for Japan (RIJ) was used for rurality. This study compared the number of items of SPI (total score, inpatient care, urgent care and ambulatory care) and SP4PC experienced by > 80% of all PCPs in the most urban (RIJ:1–10) and rural areas (RIJ: 91–100). A multivariable linear regression analysis was also performed to examine the relationship between the RIJ and SPI/SP4PC. Results Of 1,000 potential participants, 299 physicians responded to the survey (response rate: 29.9%). PCPs in the most rural areas experienced a greater number of items in the inpatientl/urgent care domains of the SPI and SP4PC than those in the most urban areas. The RIJ was the only common factor for a broader SoP in both the SPI and SP4C models. The coefficients of SoP were 0.09 (95% confidence interval: 0.03–0.16) in the SPI model and 0.017 (0.005–0.03) in the SP4PC model. Conclusion Rurality was considerably associated with SoP. The findings of this study will be helpful in understanding the SoP on rural and urban areas. |
first_indexed | 2024-03-08T16:15:06Z |
format | Article |
id | doaj.art-35196e843344425c8cff7684fbf30234 |
institution | Directory Open Access Journal |
issn | 2731-4553 |
language | English |
last_indexed | 2024-03-08T16:15:06Z |
publishDate | 2024-01-01 |
publisher | BMC |
record_format | Article |
series | BMC Primary Care |
spelling | doaj.art-35196e843344425c8cff7684fbf302342024-01-07T12:37:35ZengBMCBMC Primary Care2731-45532024-01-012511710.1186/s12875-023-02250-yPrimary care physicians working in rural areas provide a broader scope of practice: a cross-sectional studyMakoto Kaneko0Tomoya Higuchi1Ryuichi Ohta2Department of Health Data Science, Yokohama City UniversityDepartment of Family and Community Medicine, Hamamatsu University School of MedicineDepartment of Community Care, Unnan City HospitalAbstract Background Scope of practice (SoP) is an important factor for primary care physicians (PCPs). One of the strong determinants of SoP is rurality. Although Japan has several rural areas, the SoP in rural areas and the effect of rurality on SoP have not been investigated. This study aimed to describe SoP in Japanese primary care settings and examine the association between rurality and SoP. Methods This cross-sectional study included PCPs in Japan. The participants were randomly sampled from the mailing list of the Japan Primary Care Association. The Scope of Practice Inventory (SPI) and Scope of Practice for Primary Care (SP4PC) were used as indicators of SoP. The Rurality Index for Japan (RIJ) was used for rurality. This study compared the number of items of SPI (total score, inpatient care, urgent care and ambulatory care) and SP4PC experienced by > 80% of all PCPs in the most urban (RIJ:1–10) and rural areas (RIJ: 91–100). A multivariable linear regression analysis was also performed to examine the relationship between the RIJ and SPI/SP4PC. Results Of 1,000 potential participants, 299 physicians responded to the survey (response rate: 29.9%). PCPs in the most rural areas experienced a greater number of items in the inpatientl/urgent care domains of the SPI and SP4PC than those in the most urban areas. The RIJ was the only common factor for a broader SoP in both the SPI and SP4C models. The coefficients of SoP were 0.09 (95% confidence interval: 0.03–0.16) in the SPI model and 0.017 (0.005–0.03) in the SP4PC model. Conclusion Rurality was considerably associated with SoP. The findings of this study will be helpful in understanding the SoP on rural and urban areas.https://doi.org/10.1186/s12875-023-02250-yPrimary careScope of practiceRuralityJapan |
spellingShingle | Makoto Kaneko Tomoya Higuchi Ryuichi Ohta Primary care physicians working in rural areas provide a broader scope of practice: a cross-sectional study BMC Primary Care Primary care Scope of practice Rurality Japan |
title | Primary care physicians working in rural areas provide a broader scope of practice: a cross-sectional study |
title_full | Primary care physicians working in rural areas provide a broader scope of practice: a cross-sectional study |
title_fullStr | Primary care physicians working in rural areas provide a broader scope of practice: a cross-sectional study |
title_full_unstemmed | Primary care physicians working in rural areas provide a broader scope of practice: a cross-sectional study |
title_short | Primary care physicians working in rural areas provide a broader scope of practice: a cross-sectional study |
title_sort | primary care physicians working in rural areas provide a broader scope of practice a cross sectional study |
topic | Primary care Scope of practice Rurality Japan |
url | https://doi.org/10.1186/s12875-023-02250-y |
work_keys_str_mv | AT makotokaneko primarycarephysiciansworkinginruralareasprovideabroaderscopeofpracticeacrosssectionalstudy AT tomoyahiguchi primarycarephysiciansworkinginruralareasprovideabroaderscopeofpracticeacrosssectionalstudy AT ryuichiohta primarycarephysiciansworkinginruralareasprovideabroaderscopeofpracticeacrosssectionalstudy |