Characteristics of Clinic Organization and Physician Practice That Influence Patients’ Confidence in First-Contact Accessibilitya
| Characteristic | Multivariate Regression Coefficient (95% CI) |
|---|---|
| CI=confidence interval. | |
| Note: the overall adjusted R2=15.7%. | |
| a Results of hierarchical regression modeling showing the impact on achievement of optimal first-contact accessibility. The model controlled for patient age, education, and use of primary care. Only the clinic’s regular patients were included in the analysis (N = 2,725). | |
| b Some 20.3% of the variance in first-contact accessibility was attributed to between-clinic variance, of which 77.1% was explained by the final model. | |
| c Some 3.2% of the variance in first-contact accessibility was attributed to between-physician variance; physician-level characteristics decreased between-clinic variance but not between-physician variance. | |
| Mean first-contact accessibility for all clinics | 2.30 (2.26 to 2.33) |
| Clinic-level characteristicsb | |
| Practice culture | |
| Priority of rapid access (effect of 1-unit increase in the importance at the clinic on a 5-point scale centered on the average for all clinics) | 0.07 (0.01 to 0.14) |
| Clinic structure | |
| More than 10 family physicians (compared with =10) | −0.21 (−0.33 to −0.09) |
| Presence of a nurse in the clinic (compared with no nurse) | 0.12 (0.05 to 0.19) |
| Availability of 24/7 telephone access other than provincial nurse help line | 0.30 (0.10 to 0.50) |
| No. of other health care establishments with which the clinic has formal, operational agreements (effect of each additional establishment) | 0.03 (0.00 to 0.06) |
| Clinic services | |
| Availability of evening walk-in services | 0.07 (0.00 to 0.14) |
| Availability of weekend walk-in services | – |
| No. of hours open during the week above 55 hours (effect of each additional hour) | 0.008 (0.006 to 0.010) |
| Physician-level characteristicsc | |
| Next appointment in less than 1 week (compared with >1 week) | 0.09 (0.01 to 0.17) |
| No. of patients seen per hour (each additional patient above the mean of 3.4 patients per hour) | 0.02 (−0.1 to 0.05) |
| Manage urgent care by meeting patients at the hospital emergency department | −0.17 (−0.25 to −0.09) |