MULTIPLE-SITE PHYSICIAN PRACTICES AND THEIR EFFECT ON SERVICE DISTRIBUTION

Objective. This study explores the impact of multiple-site practices o n the distribution of physician services within a medical service regi on, Data Sources and Study Setting. A questionnaire was mailed to all urologists (100 percent response rate) practicing in north central Con necticut (the Hartford medical service area) and adjacent communities in September 1990. Data on community characteristics were obtained fro m the 1990 U.S. census and state government documents. Study Design. D escriptive statistics and maps were used to summarize the attributes o f single- and multiple-site practices and the communities where they w ere located. Key practice and community variables were analyzed. Data Collection/Extraction Methods. The questionnaires were coded and enter ed into a digital database with the tabulated community data. Response s of individual physicians were grouped by practice. Principal Finding s. Multiple-site practices were common. Second-order sites accounted f or 23 percent of total appointment capacity and were located in commun ities with higher than average elderly populations and incomes and low er than average minority populations. Conclusions. Analysis of multipl e-site practices is important for the accurate assessment of medical s ervice availability. Further research is needed to document the functi oning of multiple-site practices across other specialties and geograph ic areas.