Table 4.
Results of testing the relationship between difference in voice climate between professional groups and measures of patients’ experience of timely care
| Model 1 | Model 2 | Model 3 | Model 4 | |
|---|---|---|---|---|
|
| ||||
| Dependent variable = Patients’ experience of timely care as measured by | ||||
|
| ||||
| Obtained appointment as soon as needed? | Saw physician as soon as needed? | Waited reasonable time for appointment? | Received follow-up test results? | |
|
| ||||
| Mean (SD): 96% (2%) |
Mean (SD): 96% (2%) |
Mean (SD): 86% (3%) |
Mean (SD): 94% (3%) |
|
|
| ||||
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Independent variable | ||||
| Difference in reported climate (clinic leaders–staff) | 0.62 (0.41, 0.93)* | 1.05 (0.70, 1.57) | 0.61 (0.47, 0.80)** | 0.79 (0.66, 0.96)** |
| Covariates: clinic level | ||||
| Number of providers | 0.93 (0.90, 0.95)** | 0.96 (0.94, 0.98)** | 0.99 (0.97, 1.01) | 0.98 (0.97, 0.99)** |
| Number of patientsa | 1.35 (1.11, 1.49)** | 1.22 (1.11, 1.22)** | 0.90 (0.82, 1.11) | 1.00 (0.90, 1.11) |
| Workload | 1.03 (0.60, 1.74) | 1.63 (0.93, 2.86)† | 0.72 (0.43, 1.19) | 0.98 (0.76, 1.27) |
| Medical Group 1 | 0.98 (0.29, 3.30) | 1.16 (0.52, 2.62) | 0.45 (0.16, 1.23) | 0.36 (0.20, 0.64)** |
| Medical Group 2 | 0.83 (0.23, 3.02) | 0.85 (0.35, 2.03) | 0.37 (0.13, 1.11) | 0.52 (0.28, 0.97)* |
| Medical Group 3 | 1.21 (0.30, 4.82) | 0.95 (0.40, 2.29) | 0.42 (0.13, 1.39) | 0.57 (0.28, 1.16) |
| Medical Group 4 | Reference | Reference | Reference | Reference |
| Covariates: patient level | ||||
| Age group | ||||
| Ages 18–24 | 0.38 (0.12, 1.20)† | 0.23 (0.10, 0.56)** | 0.58 (0.40, 0.85)** | 0.27 (0.13, 0.56)** |
| Ages 25–34 | 0.38 (0.24, 0.60)** | 0.33 (0.18, 0.62)** | 0.52 (0.38, 0.72)** | 0.41 (0.25, 0.66)** |
| Ages 35–44 | 0.62 (0.38, 1.01)† | 0.56 (0.29, 1.09)† | 0.62 (0.44, 0.87)** | 0.49 (0.31, 0.78)** |
| Ages 45–54 | 0.56 (0.35, 0.90)* | 0.64 (0.39, 1.05)† | 0.75 (0.57, 0.97)* | 0.53 (0.38, 0.73)** |
| Ages 56–74 | 0.73 (0.51, 1.05)† | 0.87 (0.50, 1.50) | 0.82 (0.67, 1.00)† | 0.92 (0.62, 1.35) |
| Ages 65–74 | 0.97 (0.68, 1.37) | 1.73 (0.86, 3.49) | 0.89 (0.73, 1.09) | 0.86 (0.57, 1.29) |
| Ages 75 and older | Reference | Reference | Reference | Reference |
| Gender | ||||
| Male | 1.05 (0.70, 1.57) | 0.94 (0.68, 1.31) | 1.17 (1.01, 1.37)* | 1.24 (0.98, 1.57)† |
| Female | Reference | Reference | Reference | Reference |
| Education | ||||
| 8th grade or less | 1.24 (0.52, 2.97) | 0.81 (0.31, 2.15) | 0.72 (0.48, 1.08) | 0.71 (0.36, 1.39) |
| Some high school, no graduation | i 1.42 (0.56, 3.59) | 1.44 (0.58, 3.62) | 0.83 (0.56, 1.23) | 1.32 (0.72, 2.42) |
| High school graduate or GED | 1.78 (1.00, 3.17)* | 1.75 (0.90, 3.39)† | 1.03 (0.78, 1.35) | 1.32 (1.00, 1.74)* |
| Some college or 2-year degree | 1.01 (0.70, 1.45) | 1.36 (0.97, 1.91)† | 0.85 (0.71, 1.01)† | 1.16 (0.87, 1.53) |
| 4-year college graduate | 0.81 (0.52, 1.28) | 1.23 (0.75, 2.01) | 0.90 (0.72, 1.12) | 0.91 (0.66, 1.26) |
| More than 4-year college degree | Reference | Reference | Reference | Reference |
| Race | ||||
| White | 1.45 (0.89, 2.39) | 0.89 (0.46, 1.73) | 1.11 (0.85, 1.45) | 1.38 (0.94, 2.01)† |
| Black | 1.21 (0.43, 3.44) | 0.77 (0.29, 2.03) | 1.49 (1.02, 2.19* | 1.91 (0.97, 3.76)† |
| Other | Reference | Reference | Reference | Reference |
| Health status | 0.80 (0.72, 0.90)** | 0.75 (0.62, 0.92)** | 0.88 (0.80, 0.96)** | 0.96 (0.85, 1.08) |
| n | 4,959 | 3,473 | 7,212 | 5,820 |
Notes: Health status was rated on a 5-point scale: 1 = excellent health to 5 = poor health. Thus, patients with poorer health status were more likely to report receiving less timely care. Ethnicity (i.e., Hispanic vs. not) is excluded from the models presented for parsimony. It had no significant relationship to any of the timeliness of care measures, likely because of the homogeneity of the sample (98% non-Hispanic). OR = odd ratios; 95% CI = 95% confidence interval.
a
Reported per 1,000 increase in patient number.
†
p ≤ .10.
*
p ≤ .05.
**
p ≤ .01.