WHERE DO CHILDREN GO - COMPARING THE AFTER-HOURS AVAILABILITY OF FAMILY PHYSICIANS AND PRIMARY-CARE PEDIATRICIANS IN 4 CANADIAN CITIES

OBJECTIVE To describe and compare family physicians' and pediatricians ' after-hours availability for pediatric care in four Canadian cities. DESIGN Cross-sectional telephone survey. SETTING Winnipeg, Toronto, O ttawa, and Montreal pediatric and family practices. PARTICIPANTS All p rimary care pediatricians and an equal number of family physicians ran domly selected from the membership list of the College of Family Physi cians of Canada were matched by postal code. Sixty-four (10% of 282 fa mily physicians and 296 primary care pediatricians were excluded, most because no office telephone number was found. MAIN OUTCOME MEASURES ' 'After hours'' was defined as between 1800 and 0700 hours on weekdays and 0900 to 2400 hours on weekend days. Outcomes included demographics , year of graduation, day of call, time of call, and availability of p hysician. RESULTS Availability varied markedly by city rather than by specialty. Physicians were available after hours: 92.4% in Winnipeg, 5 6.0% in Toronto, 65.5% in Ottawa, and 26.9% in Montreal. Winnipeg, Tor onto, and Montreal showed no significant differences between specialti es in availability. Only Ottawa pediatricians were significantly more available than family physicians when age was taken into account (adju sted relative risk = 2.17, 95% confidence interval = 1.51 to 3.12). St ratified analysis showed no differences by day of call, time of call, or physicians' sex. Physicians graduating before 1975 in both groups t ended to be more available in all cities than younger physicians. CONC LUSIONS Regional differences appear to influence after-hours availabil ity more than specialty. Older physicians from both groups were more a vailable than younger physicians.