Satisfied patients and pediatricians: a cross-sectional analysis

Figures & data

Figure 1 Graph showing assumed relationships between variables

Abbreviation: PCP, primary care physician.

Table 1 Descriptive characteristics of the study population for assessing patient satisfaction seen with pediatricians and other PCPs during their last visit

	Pediatricians N = 9,577	Other PCPs N = 85,301
Satisfaction means (0 = min −, 100 = max +)	83.7 (30.6)	81.3 (30.9)
Year
2005–2008	2,902 (12.1)	21,154 (87.9)
2009–2012	6,533 (10.2)	57,632 (89.8)
2013–2016	142 (2.1)	6,515 (97.9)
Patient sex
Male	1,973 (5.9)	31,239 (94.1)
Female	7,604 (12.3)	54,062 (87.7)
Age category (years)
65+	1,620 (76.0)	513 (24.1)
46–64	98 (0.6)	16,672 (99.4)
35–44	1,138 (3.0)	37,442 (97.1)
25–34	2,940 (15.4)	16,110 (84.6)
18–24	3,037 (21.0)	11,461 (79.1)
<18	744 (19.3)	3,103 (80.7)
First visit
Yes	994 (7.7)	11,863 (92.3)
No	8,583 (10.5)	73,438 (89.5)
Routine visit
Yes	4,273 (11.7)	32,377 (88.3)
No	5,304 (9.1)	52,924 (90.9)
Waiting time
<15 minutes	4,932 (10.7)	41,168 (89.3)
15–30 minutes	3,180 (10.0)	28,640 (90.0)
30 minutes–1 hour	941 (8.8)	9,777 (91.2)
1 hour +	524 (8.4)	5,716 (91.6)
Visit time
<5 minutes	773 (10.1)	6,853 (89.9)
5–10 minutes	2,223 (10.4)	19,108 (89.6)
10 minutes	6,581 (10.0)	59,340 (90.0)
Region of practice
North East	2,519 (14.0)	15,528 (86.0)
South East	2,222 (6.5)	31,780 (93.5)
West	3,364 (12.3)	24,106 (87.8)
Midwest	1,472 (9.6)	13,887 (90.4)
Provider sex
Male	5,574 (8.7)	58,300 (91.3)
Female	4,003 (12.9)	27,001 (87.1)
Number of unique physicians	5,327	33,726
Ratings per physician	Min = 1, median = 1	Min = 1, median = 1
	max = 121	max = 448

Notes: All associations with pediatrician were significant with chi-square p <0.001 except visit time, with p = 0.180. Comparison of means using robust standard errors for physician cluster was significant, p <0.001.

Abbreviation: PCPs, primary care physicians.

Table 2 Multilevel model parameter estimates for varying intercept and slope model§

Fixed effects	B0	p-value	B1	p-value
Year of rating (reference: 2005–2008)
2009–2012	0.85 (0.20)	<0.001	−0.56 (0.54)	0.298
2013–2016	1.41 (0.40)	<0.001	−2.05 (2.11)	0.331
Patient sex (male vs female)	0.55 (0.15)	<0.001	−1.69 (0.56)	0.003
Age category (years; reference: <18 years)
65+	3.72 (0.98)	<0.001	−1.90 (1.35)	0.159
45–64	0.88 (0.41)	0.032	−1.65 (2.38)	0.488
35–44	0.85 (0.39)	0.029	0.74 (1.06)	0.487
25–34	0.09 (0.41)	0.826	−0.72 (0.95)	0.447
18–24	−0.55 (0.42)	0.192	0.41 (0.95)	0.668
First visit (Y vs N)	−8.70 (0.21)	<0.001	−6.64 (0.75)	<0.001
Routine visit (Y vs N)	2.21 (0.15)	<0.001	−0.37 (0.46)	0.414
Region of practice (reference: Midwest)
North East	−0.66 (0.34)	0.055	0.67 (0.88)	0.444
South East	2.46 (0.33)	<0.001	0.11 (0.88)	0.903
West	−1.11 (0.33)	0.001	2.14 (0.87)	0.014
Provider sex (male vs female)	1.53 (0.26)	<0.001	1.35 (0.61)	0.028
Waiting time (reference: <15 minutes)
15–30 minutes	−7.02 (0.16)	<0.001	0.67 (0.50)	0.182
30 minutes–1 hour	−16.7 (0.25)	<0.001	−1.56 (0.80)	0.051
1 hour +	−26.9 (0.33)	<0.001	−1.11 (1.08)	0.306
Visit time (reference: <5 minutes)
5–10 minutes	30.9 (0.31)	<0.001	4.47 (0.95)	<0.001
10 minutes	50.8 (0.29)	<0.001	3.12 (0.90)	0.001
Intercept	38.9(0.56)	0.000	1.30 (1.48)	0.381
		95% CI		95% CI
SD of provider random effect	14.7 (0.13)	14.4–15.0	18.6 (37.7)	0.3–99
Correlation between random effects	−0.77 (1.00)	−1.0–1.0
SD of residual (ε)	18.3 (0.06)	18.2–18.4

Note:

§ Model is defined by the equation: satisfaction = B0 + B1 pediatrician + ε.

Table 3 Marginally standardized mean between patient satisfaction with pediatricians and PCPs during their last visit

	Pediatrician mean (Std Err)	PCP mean (Std Err)	Diff w/95% CI
Year category	p = 0.7746	p <0.001	p = 0.438
2005–2008	81.3 (0.64)	76.9 (0.18)	4.4 (3.1–5.7)
2009–2012	81.6 (0.54)	77.8 (0.14)	3.8 (2.7–4.9)
2013–2016	80.7 (2.08)	78.4 (0.38)	2.3 (−1.8–6.5)
Patient sex	p <0.001	p <0.001	p = <0.001
Male	80.7 (0.68)	78.0(0.16)	2.8 (1.4–4.1)
Female	81.9 (0.55)	77.4(0.14)	4.4 (3.3–5.6)
Age category (years)	p = 0.001	p <0.001	p = 0.107
65+	82.9 (0.57)	80.8 (0.91)	2.1 (0.0–4.2)
45–64	80.3 (2.22)	78.0 (0.20)	2.3 (−2.0–6.7)
35–44	82.7 (0.66)	77.9 (0.15)	4.7 (3.4–6.1)
25–34	80.4 (0.45)	77.2 (0.19)	3.3 (2.3–4.2)
18–24	80.9 (0.46)	76.6 (0.22)	4.4 (3.4–5.4)
<18	81.1 (0.80)	77.1 (0.39)	4.0 (2.2–5.7)
First visit	p <0.001	p <0.001	p <0.001
Yes	68.2 (0.83)	70.1 (0.23)	−1.9 (−3.6 to −0.2)
No	83.6 (0.55)	78.8 (0.13)	4.8 (3.7–5.9)
Routine visit	p <0.001	p <0.001	p =0.414
Yes	82.6 (0.60)	79.0 (0.16)	3.6 (2.4–4.9)
No	80.8 (0.56)	76.8 (0.14)	4.0 (2.9–5.1)
Region of practice	p = 0.002	p <0.001	p = 0.037
North East	80.3 (0.68)	76.5 (0.24)	3.8 (2.3–5.2)
South East	82.8 (0.71)	79.6 (0.23)	3.2 (1.7–4.6)
West	81.3 (0.70)	76.1 (0.22)	5.2 (3.8–6.7)
Midwest	80.3 (0.78)	77.2 (0.25)	3.1 (1.5–4.7)
Provider sex	p <0.001	p <0.001	p = 0.028
Male	82.4 (0.58)	78.1 (0.14)	4.3 (3.1–5.5)
Female	79.6 (0.64)	76.6 (0.23)	3.0 (1.6–4.3)
Waiting time	p <0.001	p <0.001	p = 0.033
<15 minutes	87.5 (0.59)	83.6 (0.15)	3.9 (2.7–5.1)
15–30 minutes	81.2 (0.61)	76.6 (0.16)	4.6 (3.3–5.8)
30 minutes–1 hour	69.3 (0.84)	67.0 (0.24)	2.3(0.6–4.0)
1 hour +	59.5 (1.08)	56.7 (0.31)	2.8(0.6–5.0)
Visit time	p <0.001	p <0.001	p <0.001
<5 minutes	36.1 (0.93)	35.4 (0.28)	0.7 (−1.2–2.6)
5–10 minutes	71.4 (0.67)	66.2 (0.18)	5.2 (3.8–6.5)
10 minutes	90.0 (0.56)	86.2 (0.14)	3.8 (2.7–4.9)

Abbreviation: PCPs, primary care physicians.

Table 4 Effect decomposition of pediatricians vs PCPs on patient satisfaction rating during their last visit

	Pediatrician mean (Std Err)	PCP mean (Std Err)	Diff w/95% CI
Effect decomposition
Total effect	82.2 (0.54)§a	77.4 (0.13)§b	4.8 (3.7–5.9)
Direct effect	81.3 (0.54)§§	77.4 (0.13)	3.9 (2.8–5.0)
Indirect effect	78.3 (0.13)§§§	77.4 (0.13)	0.9 (0.9–0.9)

Notes:

§ Predicted means under waiting/visit times distributions observed in (a) pediatricians and (b) PCPs.

§§ Predicted pediatricians means under PCP waiting/visit time distributions.

§§§ Predicted PCP means under the waiting/visit time distributions observed in pediatricians.

Abbreviation: PCPs, primary care physicians.