Table 1.
Factors Related to Self-Reported Use of American Thoracic Society Guidelines for the Management of Community-acquired Pneumonia
| Hospital and Physician Characteristics* | Total N | Report Not Using ATS Guidelines† | Report Using ATS Guidelines† | Bivariate P Value | Multiple Stepwise Odds Ratio (95% CI)‡ |
|---|---|---|---|---|---|
| Hospital characteristics | |||||
| Hospital size, % | .34 | ||||
| Small (<200 beds) | 11 | 82 | 18 | ||
| Medium (200∠500 beds) | 181 | 76 | 24 | ||
| Large (>500 beds) | 72 | 68 | 32 | ||
| Teaching status, % | .27 | ||||
| Teaching | 180 | 79 | 21 | ||
| Nonteaching | 84 | 72 | 28 | ||
| Physician characteristics | |||||
| Specialty, % | <.001 | ||||
| Generalist | 210 | 77 | 23 | 1.00 | |
| Pulmonary or ID specialist | 28 | 43 | 57 | 4.51*** (1.71 to 11.90) | |
| Other specialist | 26 | 85 | 15 | 0.80* (0.25 to 2.58) | |
| Direct inpatient care, h/wk ± SD | 259 | 14.4 ± 13.4 | 18.0 ± 16.8 | .24 | |
| Direct outpatient care, h/wk ± SD | 260 | 30.2 ± 15.4 | 23.4 ± 13.0 | .001 | – |
| Total nonpatient activities, h/wk ± SD | 235 | 10.6 ± 12.0 | 17.9 ± 15.5 | <.001 | 1.02** (1.00 to 1.05) |
| Percent of total time on inpatient care ± SD | 248 | 25.1 ± 20.9 | 29.5 ± 24.5 | .32 | |
| Total work, h/wk ± SD | 250 | 56.1 ± 13.1 | 57.8 ± 12.6 | .44 | |
| Number of CAP inpatients per year ± SD | 259 | 22.4 ± 31.6 | 27.0 ± 28.3 | .07 | – |
| Journal reading, % | .02 | – | |||
| Do not read or skim articles | 125 | 81 | 19 | ||
| Read ≥1 article in most issues | 137 | 69 | 31 | ||
| Quality assurance hours, % | .26 | ||||
| <1 h per month | 155 | 77 | 23 | ||
| ≥1 h per month | 109 | 71 | 29 | ||
| Intellect personality score (0–4 = high)§± SD | 232 | 2.82 ± 0.50 | 2.99 ± 0.55 | .01 | 2.18** (1.07 to 4.40) |
| Attitudes about guidelines (0–40 = pos)″ ± SD | 258 | 16.9 ± 4.7 | 18.6 ± 4.8 | .02 | – |
| Risk avoidance (0–4 = high) ± SD | 257 | 3.67 ± 0.82 | 3.76 ± 0.92 | .45 |
Gender, age, years since graduation from medical school, university hospital affiliation, percent of income from salary, total patient care hours per week, continuing medical education hours per month, and personality trait “agreeable” were not significantly related to awareness and use of guidelines or any of the other guideline outcomes presented in Tables 1–4.
Percentages are calculated within each row.
P value < .10 but ≥ .05,
P value < .05 but ≥ 0.01,
P value < .01.
The Goldberg Personality Scale is self-rated on a 5-point response scale ranging from 0 (not at all accurate) to 4 (extremely accurate). Items were averaged to form a composite scale ranging from 0 (low personality trait intellectualism) to 4 (high personality trait intellectualism).
Attitudes about guidelines in general were assessed with the 9-item Tunis General Guideline Experience and Attitudes scale. Items were averaged to form a composite scale ranging from 0 (negative attitudes) to 4 (positive attitudes).
CAP, community-acquired pneumonia.