Mediation effects of attitudes on the generational and gender influence on Swiss General Practitioners’ home visits: a cross-sectional study

Serena Petrocchi; Qianfeng Lu; Luca Gabutti; Sandro Bonetti; Mjriam Rodella Sapia; Franco Denti; Mario Bianchetti; Peter Schulz

doi:10.57187/s.4039

Original article

Vol. 155 No. 5 (2025)

Mediation effects of attitudes on the generational and gender influence on Swiss General Practitioners’ home visits: a cross-sectional study

Serena Petrocchi⁺⁻
Qianfeng Lu⁺⁻
Luca Gabutti⁺⁻
Sandro Bonetti⁺⁻
Mjriam Rodella Sapia⁺⁻
Franco Denti⁺⁻
Mario Bianchetti
Peter Schulz⁺⁻

Cite this as:: Swiss Med Wkly. 2025;155:4039
Published: 15.05.2025

Summary

BACKGROUND: In family medicine, home visits are a tangible manifestation of patient-centred care, allowing physicians to comprehensively understand patients’ circumstances and cater to their medical and psychosocial needs. However, a recent decline in general practitioner home visits has raised significant concerns about the potential impact on care quality, particularly for older patients. General practitioners’ age, gender and attitudes may play a role. Attitudes refer to positive or negative thinking or feelings about something typically reflected in a person’s behaviour.

AIMS: To study the effects of age and gender (i.e. predictors) on the number of home visits conducted during a typical week of work (i.e. outcome) by general practitioners in Canton Ticino, Switzerland. To investigate whether attitudes (i.e. mediators) mediate the relationship between age and home visits, controlling for gender.

METHODS: A cross-sectional study was conducted from June to October 2023 on 142 family doctors (28% women) with an average age of 56.42 years (standard deviation [SD] = 11.51, range 36–83). Correlations between variables and a t-test with gender were conducted. A mediation analysis was performed to examine the potential association in which the attitudes may mediate the relationship between age and home visits, controlling for gender.

RESULTS: Older physicians conducted more home visits in a typical week (r = 0.32, p <0.001) than younger physicians, while female doctors conducted fewer visits (M = 2.39±1.8) than males (M = 4.09±2.9), t(100.8) = 3.77, p <0.001. The mediation analysis suggested that younger general practitioners tend to have more negative attitudes towards home visits, which in turn leads to a decrease in the number of home visits they make in a typical week (indirect effect B = 0.02).

CONCLUSION: There is a generational and gender effect on home visit practice in family medicine. Moreover, younger doctors hold more negative attitudes towards home visits.

References

Kao H, Conant R, Soriano T, McCormick W. The past, present, and future of house calls. Clin Geriatr Med. 2009 Feb;25(1):19–34. 10.1016/j.cger.2008.10.005
Theile G, Kruschinski C, Buck M, Müller CA, Hummers-Pradier E. Home visits - central to primary care, tradition or an obligation? A qualitative study. BMC Fam Pract. 2011 Apr;12(1):24. doi: https://doi.org/10.1186/1471-2296-12-24
Petrocchi S, Iannello P, Lecciso F, Levante A, Antonietti A, Schulz PJ. Interpersonal trust in doctor-patient relation: evidence from dyadic analysis and association with quality of dyadic communication. Soc Sci Med. 2019 Aug;235:112391. doi: https://doi.org/10.1016/j.socscimed.2019.112391
van Kempen JA, Robben SH, Zuidema SU, Olde Rikkert MG, Melis RJ, Schers HJ. Home visits for frail older people: a qualitative study on the needs and preferences of frail older people and their informal caregivers. Br J Gen Pract. 2012 Aug;62(601):e554–60. doi: https://doi.org/10.3399/bjgp12X653606
Neuner-Jehle S, Graber SM, Keizer E, Huber C, Blozik E, Rosemann T, et al. Time trends in general practitioners’ home visits for older patients: a retrospective cross-sectional study from Switzerland. Swiss Med Wkly. 2021 Jul;151(2728):w20539. doi: https://doi.org/10.4414/smw.2021.20539
Boerma WG, Groenewegen PP. GP home visiting in 18 European countries. Adding the role of health system features. Eur J Gen Pract. 2001 Jul;7(4):132–7. 10.3109/13814780109094331
Mueller Y, David S, Cohidon C, Locatelli I, Senn N. Home visits made by general practitioners in the canton of Vaud between 2006 and 2015. Swiss Med Wkly. 2019 Mar 24;149(1112):w20037. doi: https://doi.org/10.4414/smw.2019.20037
Cohidon C, Cornuz J, Senn N. Primary care in Switzerland: evolution of physicians’ profile and activities in twenty years (1993-2012). BMC Fam Pract. 2015 Aug;16(1):107. doi: https://doi.org/10.1186/s12875-015-0321-y
Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. 3rd ed. Guilford publications; 2017.

How to Cite

1.

Mediation effects of attitudes on the generational and gender influence on Swiss General Practitioners’ home visits: a cross-sectional study. Swiss Med Wkly [Internet]. 2025 May 15 [cited 2025 Oct. 19];155(5):4039. Available from: https://www.smw.ch/index.php/smw/article/view/4039

Share

This work is licensed under a Creative Commons Attribution 4.0 International License.

DOI:: https://doi.org/10.57187/s.4039

[1] Kao H, Conant R, Soriano T, McCormick W. The past, present, and future of house calls. Clin Geriatr Med. 2009 Feb;25(1):19–34. 10.1016/j.cger.2008.10.005

[2] Theile G, Kruschinski C, Buck M, Müller CA, Hummers-Pradier E. Home visits - central to primary care, tradition or an obligation? A qualitative study. BMC Fam Pract. 2011 Apr;12(1):24. doi: https://doi.org/10.1186/1471-2296-12-24

[3] Petrocchi S, Iannello P, Lecciso F, Levante A, Antonietti A, Schulz PJ. Interpersonal trust in doctor-patient relation: evidence from dyadic analysis and association with quality of dyadic communication. Soc Sci Med. 2019 Aug;235:112391. doi: https://doi.org/10.1016/j.socscimed.2019.112391

[4] van Kempen JA, Robben SH, Zuidema SU, Olde Rikkert MG, Melis RJ, Schers HJ. Home visits for frail older people: a qualitative study on the needs and preferences of frail older people and their informal caregivers. Br J Gen Pract. 2012 Aug;62(601):e554–60. doi: https://doi.org/10.3399/bjgp12X653606

[5] Neuner-Jehle S, Graber SM, Keizer E, Huber C, Blozik E, Rosemann T, et al. Time trends in general practitioners’ home visits for older patients: a retrospective cross-sectional study from Switzerland. Swiss Med Wkly. 2021 Jul;151(2728):w20539. doi: https://doi.org/10.4414/smw.2021.20539

[6] Boerma WG, Groenewegen PP. GP home visiting in 18 European countries. Adding the role of health system features. Eur J Gen Pract. 2001 Jul;7(4):132–7. 10.3109/13814780109094331

[7] Mueller Y, David S, Cohidon C, Locatelli I, Senn N. Home visits made by general practitioners in the canton of Vaud between 2006 and 2015. Swiss Med Wkly. 2019 Mar 24;149(1112):w20037. doi: https://doi.org/10.4414/smw.2019.20037

[8] Cohidon C, Cornuz J, Senn N. Primary care in Switzerland: evolution of physicians’ profile and activities in twenty years (1993-2012). BMC Fam Pract. 2015 Aug;16(1):107. doi: https://doi.org/10.1186/s12875-015-0321-y

[9] Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. 3rd ed. Guilford publications; 2017.