Influence of patient education on profiles of physician practices

Kevin Fiscella, Peter Franks

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Few data are available about the effect of patient socioeconomic status on profiles of physician practices. Objective: To determine the ways in which adjustment for patients' level of education (as a measure of socioeconomic status) changes profiles of physician practices. Design: Cross-sectional survey of patients in physician practices. Setting: Managed care organization in western New York State. Participants: A random sample of 100 primary care physicians and 50 consecutive patients seen by each physician. Measurements: Ranks of physicians for patient physical and mental health (Short Form 12-Item Health Survey) and satisfaction (Patient Satisfaction Questionnaire), adjusted for patient age, sex, morbidity, and education. Results: Physicians whose patients had a lower mean level of education had significantly better ranks for patient physical and mental health status after adjustment for patients' level of education level than they did before adjustment (P < 0.001); this result was not seen for patient satisfaction. After adjustment for patients' level of education, each 1-year decrease in mean educational level was associated with a rank that improved by 8.1 (95% CI, 6.6 to 9.6) for patient physical health status and by 4.9 (CI, 3.9 to 5.9) for patient mental health status. Adjustment for education had similar effects for practices with more educated patients and those with less educated patients. Conclusions: Profiles of physician practices that base ratings of physician performance on patients' physical and mental health status are substantially affected by patients' level of education. However, these results do not suggest that physicians who care for less educated patients provide worse care. Physician profiling should account for differences in patients' level of education.

Original languageEnglish (US)
Pages (from-to)745-751
Number of pages7
JournalAnnals of Internal Medicine
Volume131
Issue number10
StatePublished - Nov 16 1999
Externally publishedYes

Fingerprint

Patient Education
Physicians
Health Status
Mental Health
Patient Satisfaction
Social Class
Education
Social Adjustment
Sex Education
Managed Care Programs
Primary Care Physicians
Health Surveys
Cross-Sectional Studies
Organizations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Influence of patient education on profiles of physician practices. / Fiscella, Kevin; Franks, Peter.

In: Annals of Internal Medicine, Vol. 131, No. 10, 16.11.1999, p. 745-751.

Research output: Contribution to journalArticle

@article{28fc9ed5d8564361bb96af876eec7cd2,
title = "Influence of patient education on profiles of physician practices",
abstract = "Background: Few data are available about the effect of patient socioeconomic status on profiles of physician practices. Objective: To determine the ways in which adjustment for patients' level of education (as a measure of socioeconomic status) changes profiles of physician practices. Design: Cross-sectional survey of patients in physician practices. Setting: Managed care organization in western New York State. Participants: A random sample of 100 primary care physicians and 50 consecutive patients seen by each physician. Measurements: Ranks of physicians for patient physical and mental health (Short Form 12-Item Health Survey) and satisfaction (Patient Satisfaction Questionnaire), adjusted for patient age, sex, morbidity, and education. Results: Physicians whose patients had a lower mean level of education had significantly better ranks for patient physical and mental health status after adjustment for patients' level of education level than they did before adjustment (P < 0.001); this result was not seen for patient satisfaction. After adjustment for patients' level of education, each 1-year decrease in mean educational level was associated with a rank that improved by 8.1 (95{\%} CI, 6.6 to 9.6) for patient physical health status and by 4.9 (CI, 3.9 to 5.9) for patient mental health status. Adjustment for education had similar effects for practices with more educated patients and those with less educated patients. Conclusions: Profiles of physician practices that base ratings of physician performance on patients' physical and mental health status are substantially affected by patients' level of education. However, these results do not suggest that physicians who care for less educated patients provide worse care. Physician profiling should account for differences in patients' level of education.",
author = "Kevin Fiscella and Peter Franks",
year = "1999",
month = "11",
day = "16",
language = "English (US)",
volume = "131",
pages = "745--751",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "10",

}

TY - JOUR

T1 - Influence of patient education on profiles of physician practices

AU - Fiscella, Kevin

AU - Franks, Peter

PY - 1999/11/16

Y1 - 1999/11/16

N2 - Background: Few data are available about the effect of patient socioeconomic status on profiles of physician practices. Objective: To determine the ways in which adjustment for patients' level of education (as a measure of socioeconomic status) changes profiles of physician practices. Design: Cross-sectional survey of patients in physician practices. Setting: Managed care organization in western New York State. Participants: A random sample of 100 primary care physicians and 50 consecutive patients seen by each physician. Measurements: Ranks of physicians for patient physical and mental health (Short Form 12-Item Health Survey) and satisfaction (Patient Satisfaction Questionnaire), adjusted for patient age, sex, morbidity, and education. Results: Physicians whose patients had a lower mean level of education had significantly better ranks for patient physical and mental health status after adjustment for patients' level of education level than they did before adjustment (P < 0.001); this result was not seen for patient satisfaction. After adjustment for patients' level of education, each 1-year decrease in mean educational level was associated with a rank that improved by 8.1 (95% CI, 6.6 to 9.6) for patient physical health status and by 4.9 (CI, 3.9 to 5.9) for patient mental health status. Adjustment for education had similar effects for practices with more educated patients and those with less educated patients. Conclusions: Profiles of physician practices that base ratings of physician performance on patients' physical and mental health status are substantially affected by patients' level of education. However, these results do not suggest that physicians who care for less educated patients provide worse care. Physician profiling should account for differences in patients' level of education.

AB - Background: Few data are available about the effect of patient socioeconomic status on profiles of physician practices. Objective: To determine the ways in which adjustment for patients' level of education (as a measure of socioeconomic status) changes profiles of physician practices. Design: Cross-sectional survey of patients in physician practices. Setting: Managed care organization in western New York State. Participants: A random sample of 100 primary care physicians and 50 consecutive patients seen by each physician. Measurements: Ranks of physicians for patient physical and mental health (Short Form 12-Item Health Survey) and satisfaction (Patient Satisfaction Questionnaire), adjusted for patient age, sex, morbidity, and education. Results: Physicians whose patients had a lower mean level of education had significantly better ranks for patient physical and mental health status after adjustment for patients' level of education level than they did before adjustment (P < 0.001); this result was not seen for patient satisfaction. After adjustment for patients' level of education, each 1-year decrease in mean educational level was associated with a rank that improved by 8.1 (95% CI, 6.6 to 9.6) for patient physical health status and by 4.9 (CI, 3.9 to 5.9) for patient mental health status. Adjustment for education had similar effects for practices with more educated patients and those with less educated patients. Conclusions: Profiles of physician practices that base ratings of physician performance on patients' physical and mental health status are substantially affected by patients' level of education. However, these results do not suggest that physicians who care for less educated patients provide worse care. Physician profiling should account for differences in patients' level of education.

UR - http://www.scopus.com/inward/record.url?scp=0032737492&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032737492&partnerID=8YFLogxK

M3 - Article

VL - 131

SP - 745

EP - 751

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

IS - 10

ER -