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Differential Effect of Patient- and Provider-Level Factors on Patient Satisfaction Scores in Academic General Internal Medicine Clinics

  • Original Research
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Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Objective

Determine whether patient-level or provider-level factors have greater influence on patient satisfaction scores in an academic general internal medicine clinic.

Methods

Two years of data (2017–2019) from the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) surveys from ambulatory internal medicine clinic visits in an academic health center located in the Midwest United States were used. Patient satisfaction was measured using the overall provider satisfaction score (0–10), dichotomized with 9–10 defined as satisfactory and 0–8 as unsatisfactory. Provider-level independent variables included age, sex, race/ethnicity, provider type, service type, clinical effort, academic rank, and years since graduation. Patient-level factors included age, sex, race/ethnicity, education, and Epic Risk Score. Generalized mixed-effects logistic regression models were used to investigate associations between top-box satisfaction score and patient- and provider-level factors, accounting for the nesting of patients within providers.

Results

Thirty-three providers and 4597 patients were included in the analysis. Male providers (OR, 1.57; 95% CI, 1.00, 2.47), minority group 2 (OR, 3.54; 95% CI, 1.24, 10.07) and minority group 3 (OR, 6.04; 95% CI, 1.45, 25.12), faculty (OR, 3.83; 95% CI, 1.56, 9.36), and primary care providers (OR, 5.60; 95% CI, 1.62, 19.34) had increased odds of having a top-box rating compared with females, minority group 1, advanced practice providers, and perioperative providers respectively. Age was the only patient independent correlate of top-box rating with a 3% increased odds of top-box rating for every year increase in age (OR, 1.03; 95% CI 1.02, 1.03).

Conclusions

In this academic general internal medicine clinic, top-box satisfaction scores were more strongly associated with provider-level factors, including provider race/ethnicity, provider type, and service type, as opposed to patient-level factors. Further research is needed to confirm these findings and identify potential system-level interventions.

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Data Availability

A limited dataset that meets privacy and confidentiality standards of the institutional data is available from the corresponding author upon request.

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Funding

This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK118038, R01DK120861, Principal Investigator (PI): Leonard Egede, MD; K23DK132505, PI: Hawks; R21DK135965-01; PI: Dawson), National Institute on Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker), and American Diabetes Association (11–22-JDFHD-01, PI: Dawson). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    Aprill Z. Dawson PhD, MPH, Laura Hawks MD, Rebekah J. Walker PhD & Leonard E. Egede MD, MS

  2. Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA

    Aprill Z. Dawson PhD, MPH, Laura Hawks MD, Rebekah J. Walker PhD & Leonard E. Egede MD, MS

Authors
  1. Aprill Z. Dawson PhD, MPH
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  2. Laura Hawks MD
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  3. Rebekah J. Walker PhD
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  4. Leonard E. Egede MD, MS
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Contributions

LEE obtained funding for the study. LEE and RJW obtained, analyzed, and interpreted the data. LEE, RJW, AZD, and LH designed the study, drafted the article, and critically revised the manuscript for intellectual content. All authors approved the final manuscript.

Corresponding author

Correspondence to Leonard E. Egede MD, MS.

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Dawson, A.Z., Hawks, L., Walker, R.J. et al. Differential Effect of Patient- and Provider-Level Factors on Patient Satisfaction Scores in Academic General Internal Medicine Clinics. J GEN INTERN MED (2024). https://doi.org/10.1007/s11606-024-08648-3

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  • DOI: https://doi.org/10.1007/s11606-024-08648-3

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