This hotfix just looks for the registry key and does not set it. You have to get it on to the client machines through one of your preferred deployment mechanisms (GPO/Login script, etc..)
As for your other problem, I don't foresee any changes to DSAccess occurring anytime soon as DSAccess will maintain up to 10 In-site GCs and up to 200 out of site GCs. These sites have to be directly connected, not indirectly connected with the Exchange site for you to get referred to one of those out of site GCs and is based on lowest cost.
This is all going to come down to how many domain controllers you have in your environment, site topology, DNS, where your DLs are located, etc. etc..
If you have GC's close to the users in this domain, you could get around this by using the Closest GC registry key. I wrote a blog about how to deploy this key via GPO at http://blogs.technet.com/mikelag/archive/2008/01/09/how-to-update-the-outlook-adm-files-to-add-closest-gc.aspx if you are interested.