Table 1.
Predictors of disenrollment - unadjusted (Model 1) and adjusted regression (Model 2)
|
Unadjusted (single fixed |
Adjusted model* |
|||
|---|---|---|---|---|
| effect) model (Model 1) | (Model 2) | |||
|
GP Patient Survey Items |
|
|
|
|
| |
*Rate Ratio |
p-value |
*Rate Ratio |
p-value |
| (95% CI) |
(95% CI) |
|||
| 5th vs. 95th |
5th vs. 95th |
|||
| percentile |
percentile |
|||
| Helpful receptionists |
1.34 (1.25, 1.44) |
<0.001 |
0.82 (0.75, 0.89) |
<0.001 |
| Getting appointment within 2 days |
1.62 (1.51, 1.73) |
<0.001 |
1.09 (1.02, 1.16) |
0.016 |
| Booking appointment in advance |
1.07 (0.99, 1.14) |
0.076 |
1.07 (1.00, 1.14) |
0.055 |
| Seeing preferred doctor |
0.77 (0.72, 0.83) |
<0.001 |
0.90 (0.84, 0.96) |
0.001 |
| Satisfaction with opening hours |
1.64 (1.53, 1.76) |
<0.001 |
0.65 (0.60, 0.70) |
<0.001 |
| Doctor/patient communication |
4.63 (4.35, 4.94) |
<0.001 |
1.03 (0.87, 1.21) |
0.782 |
| Confidence and trust in doctor |
4.85 (4.56, 5.16) |
<0.001 |
1.26 (1.06, 1.49) |
0.011 |
| Nurse/patient communication |
1.71 (1.60, 1.84) |
<0.001 |
0.90 (0.84, 0.96) |
<0.001 |
| Overall satisfaction |
3.91 (3.66, 4.18) |
<0.001 |
3.46 (2.86, 4.18) |
<0.001 |
|
Doctors’ Characteristics |
|
|
|
|
| |
Rate Ratio (95% CI) 95th vs.5th |
p-value |
Rate Ratio (95% CI) 95th vs. 5th |
p-value |
| percentile |
||||
| percentile | ||||
| Mean years since FP qualification |
3.58 (3.35, 3.83) |
<0.001 |
1.08 (1.01, 1.15) |
0.015 |
| Proportion of male FPs |
2.21 (2.07, 2.36) |
<0.001 |
1.00 (0.95, 1.05) |
0.807 |
| Proportion of overseas qualified FPs |
3.52 (3.35, 3.71) |
<0.001 |
0.96 (0.94, 0.98) |
<0.001 |
| Patients per full time equivalent FP |
1.88 (1.78, 1.98) |
<0.001 |
0.84 (0.81, 0.88) |
<0.001 |
|
Practice Characteristics |
|
|
|
|
| |
Rate Ratio (95% CI) |
p-value |
Rate Ratio (95% CI) |
p-value |
| Number of FPs: |
|
|
|
|
| 1† |
4.29 (4.05, 4.56) |
<0.001 |
2.75 (2.56, 2.95) |
<0.001 |
| 2 |
2.92 (2.76, 3.09) |
2.10 (1.99, 2.22) |
||
| 3 |
2.03 (1.91, 2.16) |
1.68 (1.59, 1.76) |
||
| 4 |
1.52 (1.43, 1.61) |
1.42 (1.35, 1.49) |
||
| 5 |
1.23 (1.16, 1.31) |
1.19 (1.13, 1.25) |
||
| 6-9‡ |
Ref |
Ref |
||
| 10 or More |
0.79 (0.73, 0.86) |
0.81 (0.76, 0.87) |
||
| Number of practices within 1km: |
|
|
|
|
| 0† |
Ref |
<0.001 | Ref |
<0.001 |
| 1 |
1.53 (1.44, 1.62) |
1.21 (1.16, 1.26) |
||
| 2 |
1.68 (1.57, 1.79) |
1.21 (1.16, 1.27) |
||
| 3 |
1.94 (1.81, 2.09) |
1.23 (1.17, 1.30) |
||
| 4 |
2.39 (2.20, 2.59) |
1.32 (1.24, 1.40) |
||
| 5 |
2.29 (2.09, 2.50) |
1.24 (1.16, 1.32) |
||
| 6-9‡ |
2.68 (2.49, 2.88) |
1.36 (1.28, 1.44) |
||
| 10 or More | 2.97 (2.61, 3.38) | 1.40 (1.27, 1.55) | ||
* Also adjusted for practice level patient demographics
† Contains 5th percentile
‡ Contains 95th percentile
* Rate ratios are the relative increase in disenrollment rate associated with moving from the 95th to 5th percentile for patient experience measures, and moving from the 5th to the 95th percentile for other continuous variables. Rate ratio > 1 implies:
• For patient experience - disenrollment more likely at worse performing practices compared to better practices
• For doctor characteristics - disenrollment more likely at practices with higher values compared to practices with lower values
• For practice characteristics - disenrollment more likely compared to reference category