Table 2.
Physician and patient characteristics by diagnostic exam performance tertile
| Total | Diagnosis question per cent correct | P value* | |||
| Top (78.5–95.8) |
Middle (71.4–78.4) |
Bottom (42.9–71.3) |
|||
| Exam performance, mean (SD)* | |||||
| Diagnosis question per cent correct | 74.5 (0.4) | 84.3 (0.3) | 74.8 (0.1) | 65.5 (0.3) | <0.001 |
| Other question per cent correct | 72.6 (0.7) | 80.2 (1.0) | 72.1 (1.1) | 66.4 (1.5) | <0.001 |
| Treatment question per cent correct | 77.3 (0.3) | 83.4 (0.4) | 77.2 (0.4) | 72.0 (0.5) | <0.001 |
| Physician characteristics, count (%) | |||||
| Female physician | 19 428 (39.9) | 6546 (43.8) | 6357 (37.5) | 6525 (39.0) | 0.37 |
| US born physician | 28 462 (58.5) | 9284 (62.1) | 9932 (58.6) | 9246 (55.3) | 0.37 |
| US medical school | 31 960 (65.7) | 10 471 (70.0) | 10 900 (64.3) | 10 589 (63.3) | 0.30 |
| Practice type | |||||
| Solo physician practice | 9452 (19.4) | 1914 (12.8) | 3462 (20.4) | 4076 (24.4) | 0.009 |
| Small group practice (2–10) | 20 563 (42.3) | 5543 (37.1) | 7529 (44.4) | 7491 (44.8) | 0.19 |
| Medium physicians group practice (11–50) | 7442 (15.3) | 2899 (19.4) | 2402 (14.2) | 2141 (12.8) | 0.25 |
| Large physician group practice (>50 physicians) | 5391 (11.1) | 2150 (14.4) | 1655 (9.8) | 1586 (9.5) | 0.14 |
| Academic practice | 2708 (5.6) | 1447 (9.7) | 697 (4.1) | 564 (3.4) | <0.001 |
| Other practice | 3076 (6.3) | 1005 (6.7) | 1211 (7.1) | 860 (5.1) | 0.59 |
| Beneficiary characteristics | |||||
| Beneficiary race, count (per cent) | |||||
| White | 40 086 (82.4) | 12 652 (84.6) | 13 778 (81.3) | 13 656 (81.7) | 0.13 |
| Black | 3958 (8.1) | 926 (6.2) | 1609 (9.5) | 1423 (8.5) | 0.03 |
| Other | 4588 (9.4) | 1380 (9.2) | 1569 (9.3) | 1639 (9.8) | 0.88 |
| Beneficiary age (per year), mean (SD)* | 76.6 (0.1) | 76.8 (0.1) | 76.5 (0.1) | 76.6 (0.1) | 0.23 |
| Chronic Condition Data Warehouse (CCW) conditions, count (per cent) | |||||
| Alzheimer’s disease and related disorders or senile dementia | 5151 (10.6) | 1497 (10.0) | 1793 (10.6) | 1861 (11.1) | 0.16 |
| Alzheimer’s disease | 2061 (4.2) | 627 (4.2) | 704 (4.2) | 730 (4.4) | 0.82 |
| Acute myocardial infarction | 1408 (2.9) | 394 (2.6) | 494 (2.9) | 520 (3.1) | 0.13 |
| Anaemia | 22 450 (46.2) | 6706 (44.8) | 7766 (45.8) | 7978 (47.7) | 0.11 |
| Asthma | 4424 (9.1) | 1313 (8.8) | 1548 (9.1) | 1563 (9.3) | 0.39 |
| Atrial fibrillation | 4225 (8.7) | 1265 (8.5) | 1478 (8.7) | 1482 (8.9) | 0.69 |
| Breast cancer | 2485 (5.1) | 779 (5.2) | 831 (4.9) | 875 (5.2) | 0.48 |
| Colorectal cancer | 1139 (2.3) | 357 (2.4) | 406 (2.4) | 376 (2.2) | 0.68 |
| Endometrial cancer | 352 (0.7) | 113 (0.8) | 109 (0.6) | 130 (0.8) | 0.39 |
| Lung cancer | 435 (0.9) | 151 (1.0) | 152 (0.9) | 132 (0.8) | 0.19 |
| Prostate cancer | 1662 (3.4) | 507 (3.4) | 600 (3.5) | 555 (3.3) | 0.66 |
| Cataract | 31 095 (63.9) | 9601 (64.2) | 10 773 (63.5) | 10 721 (64.1) | 0.74 |
| Heart failure | 9207 (18.9) | 2786 (18.6) | 3155 (18.6) | 3266 (19.5) | 0.54 |
| Chronic kidney disease | 6904 (14.2) | 2083 (13.9) | 2392 (14.1) | 2429 (14.5) | 0.62 |
| Chronic obstructive pulmonary disease | 9108 (18.7) | 2635 (17.6) | 3165 (18.7) | 3308 (19.8) | 0.02 |
| Depression | 12 042 (24.8) | 3728 (24.9) | 4145 (24.4) | 4169 (24.9) | 0.83 |
| Diabetes | 13 296 (27.3) | 3947 (26.4) | 4590 (27.1) | 4759 (28.5) | 0.16 |
| Glaucoma | 10 030 (20.6) | 3086 (20.6) | 3501 (20.6) | 3443 (20.6) | 0.99 |
| Hip/pelvic fracture | 1531 (3.1) | 430 (2.9) | 535 (3.2) | 566 (3.4) | 0.15 |
| Hyperlipidaemia | 37 132 (76.4) | 11 266 (75.3) | 12 898 (76.1) | 12 968 (77.6) | 0.11 |
| Benign prostatic hyperplasia | 5815 (12.0) | 1792 (12.0) | 1987 (11.7) | 2036 (12.2) | 0.76 |
| Hypertension | 37 607 (77.3) | 11 345 (75.8) | 13 011 (76.7) | 13 251 (79.3) | <0.001 |
| Hypothyroidism | 11 425 (23.5) | 3490 (23.3) | 3862 (22.8) | 4073 (24.4) | 0.25 |
| Ischaemic heart disease | 18 713 (38.5) | 5616 (37.5) | 6393 (37.7) | 6704 (40.1) | 0.06 |
| Osteoporosis | 14 171 (29.1) | 4372 (29.2) | 4794 (28.3) | 5005 (29.9) | 0.34 |
| Rheumatoid arthritis | 23 352 (48.0) | 6879 (46.0) | 8275 (48.8) | 8198 (49.0) | 0.02 |
| Stroke | 6255 (12.9) | 1880 (12.6) | 2212 (13.0) | 2163 (12.9) | 0.70 |
| Number of chronic conditions, count (per cent) | |||||
| ≤4 | 5066 (10.4) | 1459 (9.8) | 1744 (10.3) | 1863 (11.1) | 0.08 |
| 5–7 | 16 861 (34.7) | 5392 (36.0) | 5981 (35.3) | 5488 (32.8) | 0.006 |
| 8–10 | 16 230 (33.4) | 4907 (32.8) | 5664 (33.4) | 5659 (33.8) | 0.35 |
| ≥11 | 10 475 (21.5) | 3200 (21.4) | 3567 (21.0) | 3708 (22.2) | 0.28 |
| Mental health visit, count (per cent) | 6347 (13.1) | 2040 (13.6) | 2119 (12.5) | 2188 (13.1) | 0.46 |
| Hierarchical Condition Category score, mean (SD)* | 0.98 (0.01) | 0.96 (0.01) | 0.98 (0.01) | 0.99 (0.01) | 0.19 |
| Household medium income, mean $ (SD)* | 59 852 (643) | 61 574 (1106) | 59 113 (1144) | 59 063 (1075) | 0.19 |
| Medicaid dual eligible, count (per cent) | 6392 (13.1) | 1793 (12.0) | 2411 (14.2) | 2188 (13.1) | 0.28 |
| Rural county residence, count (per cent) | 7392 (15.2) | 2207 (14.8) | 2866 (16.9) | 2319 (13.9) | 0.64 |
| Visit characteristics | |||||
| Visit with same doctor in last year, count (per cent) | 37 726 (77.6) | 11 369 (76.0) | 13 154 (77.6) | 13 203 (79.0) | 0.08 |
| Visit with any physician in last year, count (per cent) | 44 852 (92.2) | 13 711 (91.7) | 15 647 (92.3) | 15 494 (92.7) | 0.08 |
| Days since last visit with any physician (if any visit in last year), mean (SD)* | 144.2 (0.6) | 147.1 (0.8) | 144.4 (1.0) | 141.4 (1.3) | <0.001 |
| ED visit in prior year, count (per cent) | 8101 (16.7) | 2428 (16.2) | 2879 (17.0) | 2794 (16.7) | 0.43 |
| Days since last ED visits (if ED visit in last year), mean (SD)* | 222.8 (0.9) | 221.2 (1.5) | 223.5 (1.5) | 223.4 (1.5) | 0.47 |
| Hospitalisation in prior year, count (per cent) | 4227 (8.7) | 1280 (8.6) | 1489 (8.8) | 1458 (8.7) | 0.85 |
| Days since last hospitalisation (if hospitalisation in last year), mean (SD)* | 229.6 (1.2) | 229.1 (2.1) | 229.7 (2.1) | 230.1 (1.9) | 0.95 |
| Index visit diagnosis groups, count (per cent) | |||||
| Abscess | 1005 (2.1) | 268 (1.8) | 394 (2.3) | 343 (2.1) | 0.21 |
| Anaemia | 12 410 (25.5) | 3817 (25.5) | 4369 (25.8) | 4224 (25.3) | 0.93 |
| Aortic aneurysm | 11 491 (23.6) | 3495 (23.4) | 4165 (24.6) | 3831 (22.9) | 0.18 |
| Appendicitis | 2584 (5.3) | 845 (5.6) | 949 (5.6) | 790 (4.7) | 0.01 |
| Bacteraemia | 5567 (11.4) | 1660 (11.1) | 1929 (11.4) | 1978 (11.8) | 0.83 |
| Congestive heart failure | 12 137 (25.0) | 3633 (24.3) | 4221 (24.9) | 4283 (25.6) | 0.67 |
| Acute coronary syndrome | 16 228 (33.4) | 4627 (30.9) | 5740 (33.9) | 5861 (35.1) | 0.02 |
| Depression | 12 637 (26.0) | 3932 (26.3) | 4312 (25.4) | 4393 (26.3) | 0.78 |
| Fracture | 13 409 (27.6) | 4324 (28.9) | 4364 (25.7) | 4721 (28.2) | 0.11 |
| Pulmonary embolism | 8534 (17.5) | 2683 (17.9) | 2984 (17.6) | 2867 (17.1) | 0.71 |
| Pneumonia | 12 183 (25.1) | 3773 (25.2) | 4224 (24.9) | 4186 (25.0) | 0.97 |
| Spinal cord compression | 6386 (13.1) | 1985 (13.3) | 2218 (13.1) | 2183 (13.1) | 0.94 |
| Stroke | 10 026 (20.6) | 3003 (20.1) | 3542 (20.9) | 3481 (20.8) | 0.79 |
*P values and SD accounted for correlated errors within physicians.
ED, emergency department.