Productivity, quality, and patient satisfaction

Fairchild, David G.; McLoughlin, Karen Sax; Gharib, Soheyla D.; Horský, J; Portnow, Michelle; Richter, James M.; Gagliano, Nancy; Bates, David W.

doi:10.1111/j.1525-1497.2001.01111.x

Cited by 53 publications

(22 citation statements)

References 23 publications

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“…Definitions of the variables are provided in Table 1 previous literature, [17][18][19] our findings also suggest that physicians with lower clinical FTEs had higher patient satisfaction scores, after accounting for direct and indirect associations with continuity and access to care measures. Overall, this work suggests that PCPs who choose to work fewer clinical hours may have worse continuity and access outcomes, but they may provide a better patient experience.…”

Section: Discussionsupporting

confidence: 52%

“…16 Furthermore, the patient perspective on being cared for by a part-time PCP is not well understood. One systematic review concluded that provider work hours had no relationship with patient satisfaction, [16][17][18] yet because of the lack of welldesigned studies, the authors could not make strong conclusions about these findings. 13 However, there are several possible reasons why physicians with fewer clinical full time equivalents (FTEs) may have higher patient satisfaction scores.…”

Section: Introductionmentioning

confidence: 99%

“…21 There are several limitations with the current literature associating a physician's clinical work hours with patient satisfaction. A common limitation is the use of an arbitrary discrete cutoff to define part-time versus full-time, 16,17,21 with cutoffs ranging from 20 clinical hours/week 17 to 40 h/week of self-reported work. 16 No study has yet controlled for either continuity of care or access, which have both been associated with patient satisfaction, [28][29][30][31] or accounted for their potential mediating relationship, since continuity of care and access are also likely to be affected by a physician's work hours.…”

Section: Introductionmentioning

confidence: 99%

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Patients Report Better Satisfaction with Part-Time Primary Care Physicians, Despite Less Continuity of Care and Access

et al. 2014

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BACKGROUND:The growing number of primary care physicians (PCPs) reducing their clinical work hours has raised concerns about meeting the future demand for services and fulfilling the continuity and access mandates for patient-centered care. However, the patient's experience of care with part-time physicians is relatively unknown, and may be mediated by continuity and access to care outcomes. OBJECTIVE: We aimed to examine the relationships between a physicians' clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. DESIGN: We used a multi-level structural equation estimation, with continuity and access modeled as mediators, for a cross-section in 2010. PARTICIPANTS: The study included family medicine (n=104) and internal medicine (n=101) physicians in a multi-specialty group practice, along with their patient satisfaction survey responses (n=12,688). MAIN MEASURES: Physician level FTE, continuity of care received by patients, continuity of care provided by physician, and a Press Ganey patient satisfaction with the physician score, on a 0-100 % scale, were measured. Access to care was measured as days to the third nextavailable appointment. KEY RESULTS: Physician FTE was directly associated with better continuity of care received (0.172 % per FTE, p<0.001), better continuity of care provided (0.108 % per FTE, p<0.001), and better access to care (−0.033 days per FTE, p<0.01), but worse patient satisfaction scores (−0.080 % per FTE, p=0.03). The continuity of care provided was a significant mediator (0.016 % per FTE, p<0.01) of the relationship between FTE and patient satisfaction; but overall, reduced clinical work hours were associated with better patient satisfaction (−0.053 % per FTE, p=0.03). CONCLUSIONS: These results suggest that PCPs who choose to work fewer clinical hours may have worse continuity and access, but they may provide a better patient experience. Physician workforce planning should consider these care attributes when considering the role of parttime PCPs in practice redesign efforts and initiatives to meet the demand for primary care services.KEY WORDS: part-time work; continuity of care; access to care; patient satisfaction.

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patients Report Better Satisfaction with Part-Time Primary Care Physicians, Despite Less Continuity of Care and Access

et al. 2014

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“…RVUs can be used as an objective measure of productivity, such as comparisons based on RVUs per hour [19]. RVUs can also be applied to cost analysis and to benchmarking [20,21].…”

Section: Discussionmentioning

confidence: 99%

Responsibility loadings for dental services by general dentists

Brennan

Spencer

2010

BMC Health Serv Res

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BackgroundResponsibility loadings determine relative value units of dental services that translate services into a common scale of work effort. The aims of this paper were to elicit responsibility loadings for a subset of dental services and to relate responsibility loadings to ratings of importance of the components of responsibility.MethodsResponsibility loadings and ratings of components of responsibility were collected using mailed questionnaires from a random sample of Australian private general practice dentists in 2007 (response rate = 77%).ResultsMedian responsibility loadings were 1.25 for an initial oral examination and for a 3+-surface amalgam restoration, 1.50 for a simple extraction and for root canal obturation (single canal), and 1.75 for subgingival curettage (per quadrant). Across the five services coefficients from a multivariate logit model showed that ratings of importance of knowledge (0.34), dexterity (0.24), physical effort (0.28) and mental effort (0.48) were associated with responsibility loadings (P < 0.05).ConclusionsThe elicited median responsibility loadings showed agreement with previous estimates indicating convergent validity. Components of responsibility were associated with loadings indicating that components can explain and predict responsibility aspects of dental service provision.

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“…1 Previous studies identified system 2–5 and provider 6–16 characteristics that contribute to variations in care quality.…”

Section: Introductionmentioning

confidence: 99%

Is Patient-Perceived Severity of a Geriatric Condition Related to Better Quality of Care?

et al. 2011

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Background Care for falls and urinary incontinence (UI) among older patients is inadequate. One possible explanation is that physicians provide less recommended care to patients who are not as concerned about their falls and UI. Objective To test whether patient-reported severity for two geriatric conditions, falls and UI, is associated with quality of care. Research Design Prospective cohort study of elders with falls and/or fear of falling (n=384) and UI (n=163). Subjects Participants in the Assessing Care of Vulnerable Elders-2 Study (2002–3), which evaluated an intervention to improve the care for falls and UI among older (age ≥75) ambulatory care patients with falls/fear of falling or UI. Measures Falls Efficacy Scale (FES) and the Incontinence Quality of Life (IQOL) surveys measured at baseline, quality of care measured by a 13-month medical record abstraction. Results There was a small difference in falls quality scores across the range of FES, with greater patient-perceived falls severity associated with better odds of passing falls quality indicators (OR 1.11 (95% CI 1.02–1.21) per 10-point increment in FES). Greater patient-perceived UI severity (IQOL score) was not associated with better quality of UI care. Conclusions Although older persons with greater patient-perceived falls severity receive modestly better quality of care, those with more distressing incontinence do not. For both conditions, however, even the most symptomatic patients received less than half of recommended care. Low patient-perceived severity of condition is not the basis of poor care for falls and UI.

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Productivity, quality, and patient satisfaction

Cited by 53 publications

References 23 publications

Patients Report Better Satisfaction with Part-Time Primary Care Physicians, Despite Less Continuity of Care and Access

Patients Report Better Satisfaction with Part-Time Primary Care Physicians, Despite Less Continuity of Care and Access

Responsibility loadings for dental services by general dentists

Is Patient-Perceived Severity of a Geriatric Condition Related to Better Quality of Care?

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