The relationship between work hours and utilization of general practitioners in four Canadian provinces

Objective. To assess whether long work hours act as a barrier to accessing general practitioner (GP) services. Data Sources. Secondary data from the 1996/1997 National Population Health Survey (NPHS) and administrative health services utilization data from four Canadian provinces. Study Design. This study was cross-sectional, however, employment variables and GP utilization were reflective of the 12-month period preceding the NPHS interview date. Negative binomial regression was used to model the relationship between the number of GP visits in a 1-year period and employment-related variables while adjusting for other determinants of GP utilization including education, income, and health status. Data Extraction Methods. NPHS and administrative data were linked to create an analysis file. Principal Findings. Subjects with long, standard work hours (>45 hours/week, with most hours during the day) had significantly lower GP utilization rates compared with full-time workers. White-collar workers with long work hours visited a GP significantly less often than white-collar workers with regular hours. Conclusions. Long work hours may act as a nonfinancial barrier to accessing GP services independent of health status.