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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Main Authors: Makoto Kaneko, Tomoya Higuchi, Ryuichi Ohta
Format: Article
Language:English
Published: BMC 2024-01-01
Series:BMC Primary Care
Subjects:
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.
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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