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. Author manuscript; available in PMC: 2013 Aug 27.
Published in final edited form as: Arch Intern Med. 2012 Jan 9;172(1):23–31. doi: 10.1001/archinternmed.2011.580

Table 5.

Multivariate Correlates of Provider and Staff Morale, Job Satisfaction, and Burnouta

Variable Odds Ratio (95% CI)
Provider
Staff
Morale Job Satisfaction Burnout Moraleb Job Satisfaction Burnout
Models Without Work Environment – PCMH Subscales
Access and communication with patients 1.06 (0.63–1.81) 0.86 (0.52–1.43) 0.76 (0.47–1.23) 2.07 (1.13–3.81)c 1.54 (0.92–2.60) 1.09 (0.64–1.84)
Tracking data 0.98 (0.65–1.48) 0.77 (0.51–1.17) 0.92 (0.63–1.34) 0.72 (0.45–1.17) 0.92 (0.59–1.43) 0.94 (0.61–1.45)
Care management 0.69 (0.36–1.32) 0.73 (0.38–1.42) 0.69 (0.38–1.26) 0.88 (0.46–1.68) 0.66 (0.37–1.16) 0.68 (0.38–1.20)
Quality improvement 2.64 (1.47–4.75)d 2.45 (1.42–4.23)d 1.01 (0.61–1.67) 3.62 (1.84–7.09)d 2.55 (1.42–4.57)e 2.32 (1.31–4.12)e
Models Without Work Environment – Total PCMH Score
Total PCMH score 1.64 (0.95–2.81)f 1.04 (0.62–1.76) 0.48 (0.30–0.77)e 2.63 (1.47–4.71)d 1.63 (0.99–2.67)f 1.26 (0.80–1.99)
Models With Work Environment – PCMH Subscales
Access and communication with patients 0.99 (0.60–1.63) 0.85 (0.52–1.41) 0.74 (0.46–1.21) 1.78 (1.00–3.17)c 1.42 (0.84–2.38) 1.13 (0.67–1.93)
Tracking data 0.92 (0.62–1.37) 0.73 (0.48–1.12) 0.92 (0.62–1.35) 0.64 (0.40–1.03)f 0.87 (0.56–1.36) 0.92 (0.60–1.42)
Care management 0.67 (0.36–1.26) 0.72 (0.37–1.40) 0.64 (0.34–1.18) 1.02 (0.56–1.88) 0.74 (0.41–1.31) 0.68 (0.38–1.21)
Quality improvement 1.19 (0.55–2.54) 1.69 (0.80–3.56) 0.63 (0.30–1.30) 1.66 (0.71–3.87) 1.75 (0.80–3.81) 2.50 (1.12–5.57)c
Work environment 2.29 (1.31–3.97)e 1.45 (0.85–2.47) 1.59 (0.95–2.69)f 2.43 (1.29–4.59)e 1.50 (0.84–2.68) 0.91 (0.52–1.62)
Models With Work Environment – Total PCMH Score
Total PCMH score 0.66 (0.34–1.26) 0.49 (0.24–0.99)c 0.33 (0.18–0.62)d 0.97 (0.52–1.82) 0.87 (0.48–1.57) 0.88 (0.50–1.54)
Work environment 2.51 (1.62–3.90)d 2.03 (1.30–3.17)e 1.43 (0.97–2.12)f 3.34 (2.02–5.54)d 2.20 (1.39–3.48)d 1.55 (1.01–2.36)c

Abbreviation: PCMH, patient-centered medical home.

a

Odds ratios (95% CIs) are reported from multivariate generalized estimating equation logistic regression analyses. Odds ratios indicate how much a 10% increase in the PCMH subscale or covariate score increases the odds that providers and staff rated their workplace morale highly, were satisfied with their job, or had less burnout. In addition to the PCMH scores and work environment covariate (when listed), all multivariate models contained covariates on the presence of an electronic medical record, provider shortage, nursing shortage, and years since the end of clinical training. For each set of PCMH scores and covariates, we fit 3 multivariate models, one for each outcome of morale, job satisfaction, and burnout.

b

Cut points for morale, job satisfaction, and burnout are as follows: For morale, “poor” and “fair” were combined vs “good,” “very good,” and “excellent.” For job satisfaction, “strongly disagree,” “disagree,” and “neither agree nor disagree” were combined vs “agree” and “strongly agree.” For burnout, “I feel completely burned out and often wonder if I can go on,” “The symptoms of burnout that I’m experiencing won’t go away. I think about frustrations at work a lot,” and “I have one or more symptoms of burnout, such as physical or emotional exhaustion” were combined vs “Occasionally I am under stress at work, but I don’t feel burned out” and “I enjoy my work. I have no symptoms of burnout.”

c

P < .05.

d

P < .001.

e

P < .01.

f

P >.05 and <.10.