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. 2011 Feb;6(2):334–343. doi: 10.2215/CJN.06240710

Table 3.

Physician and hypothetical patient scenario characteristics, and physician attitudes associated with desire for collaborative care

Characteristic Percentages Desiring Collaborative Care
PCPs
 Nephrologists
Unadjusted Proportion Adjusted Proportion (95% confidence interval) P Unadjusted Proportion Adjusted Proportion (95% confidence interval) P
Physician characteristics
    years in practice 0.423 0.656
        0 to 10 82 82 (reference) 91 91 (reference)
        >10 89 89 (68 to 97) 97 94 (60 to 99)
    region
        Northeast 85 85 (reference) 0.838 96 96 (reference) –
        Midwest 89 83 (42 to 97) 0.294 92 85 (11 to 100) 0.424
        South 79 69 (28 to 93) 0.760 92 92 (32 to 100) 0.603
        West 85 88 (56 to 98) 100 a –
    practice setting 0.215 0.286
        nonacademic 83 83 (reference) 93 93 (reference)
        academic center 95 95 (69 to 99) 95 98 (80 to 100)
    regular participation in CME 0.088 0.770
        no 77 77 (reference) 78 78 (reference)
        yes 88 92 (74 to 98) 96 88 (5 to 100)
    knowledge of referral guidelines 0.483 0.051
        no/unsure 82 82 (reference) 79 79 (reference)
        yes 91 88 (65 to 97) 98 98 (79 to 100)
    correct estimation of GFR 0.496 –
        no 90 90 (reference) 100 100 (reference)
        yes 84 80 (29 to 98) 94 b
Patient scenario characteristics
    patient scenario race 0.865 0.756
        white 88 88 (reference) 95 95 (reference)
        black 82 89 (69 to 97) 93 96 (74 to 100)
    patient scenario comorbidity 0.021 0.697
        hypertension only 75 75 (reference) 95 95 (reference)
        diabetes and hypertension 92 94 (80 to 98) 93 93 (55 to 99)
Physician attitudes
    perceived ancillary support 0.621 0.328
        lacking 85 85 (reference) 97 97 (reference)
        sufficient 85 80 (48 to 95) 93 83 (10 to 100)
    medical care I provide slows diseasec 0.049 –
        no 75 75 (reference) 100 100 (reference)
        yes 88 92 (75 to 98) 94 d
    insurance plays role in referrale 0.033 –
        never/rarely 88 88 (reference) 94 94 (reference)
        often/always 56 42 (9 to 85) 96 e
    difficulty referring to nephrologyf 0.246 n/a
        never/rarely 84 84 (reference) – –
        often/always 94 92 (75 to 98)
    patients referred too lateg 0.798
        disagree – – NA 93 93 (reference)
        agree 95 94 (66 to 99)
    inappropriate medsh 0.895
        disagree – – NA 94 94 (reference)
        agree 94 95 (47 to 100)
    practice too full to accommodatei 0.697
        disagree – – NA 95 95 (reference)
        agree 91 75 (2 to 100)
a

All nephrologists from the West desired collaborative care.

b

All nephrologists who correctly identified the GFR desired collaborative care.

c

Physicians were asked if they believed the medical care they implemented for patients such as in the hypothetical scenario helps to slow progression of kidney disease and improve outcomes.

d

All nephrologists who felt their care was helpful desired collaborative care.

e

PCPs were asked how often insurance plays a role in their decision to refer to nephrology. Nephrologists were asked if they felt health insurance restricts PCPs abilities to refer early. All nephrologists who felt insurance played a role desired collaborative care.

f

PCPs were asked how often they had difficulty referring to nephrology.

g

Nephrologists were asked if they felt patients were referred to nephrology late in their care, without time to potentially slow progression of their CKD.

h

Nephrologists were asked if they felt patients referred to them have been prescribed inappropriate medication regimens.

i

Nephrologists were asked if they felt they had little capacity to accommodate early CKD patients.