Associations Between Work Dissatisfaction and Physician and Practice Characteristics
| Physician Characteristics | No. | Single Independent Variables OR (CI 95%) | Multiple Analysis Final Model OR (CI 95%) |
|---|---|---|---|
| (N = 10’191) | |||
| GP sex | |||
| Male | 6,693 | ||
| Female | 5,324 | 1.06 (0.94-1.22) | 1.05 (0.90-1.22) |
| GP age, y | |||
| <35 | 1,162 | ||
| 35-44 | 2,921 | 1.01 (0.90-1.13) | 1.02 (0.94-1.11) |
| 45-54 | 3,155 | 1.35 (1.19-1.53) | 1.32 (1.17-1.49) |
| 55-64 | 3,561 | 1.27 (1.13-1.43) | 1.25 (1.10-1.42) |
| ≥65 | 1,230 | 0.69 (0.54-0.89) | 0.67 (0.52-0.88) |
| Rural/Urban area | |||
| Rural | 5,065 | ||
| Urban | 6,898 | 1.08 (0.98-1.18) | 1.12 (1.03-1.22) |
| Practice organizational & functional features | |||
| Weekly workload (hours/week) | |||
| ≤40 | 6,150 | ||
| 41-50 | 3,444 | 1.11 (0.97-1.26) | 1.14 (1.01-1.27) |
| >50 | 2,315 | 1.26 (1.09-1.47) | 1.26 (1.12-1.42) |
| Administrative task (% total workload) | |||
| ≤10 | 4,044 | ||
| 11-20 | 3,957 | 1.10 (0.97-1.25) | 1.14 (1.01-1.29) |
| >20 | 3,839 | 1.55 (1.39-1.74) | 1.55 (1.37-1.73) |
| GP FTE in the practice | |||
| 1 | 2,351 | ||
| 2 | 2,150 | 0.90 (0.78-1.05) | 0.97 (0.80-1.17) |
| 3-5 | 4,009 | 0.74 (0.64-0.86) | 0.83 (0.69-0.99) |
| 6-10 | 2,321 | 0.68 (0.52-0.88) | 0.76 (0.60-0.96) |
| >10 | 804 | 0.77 (0.55-1.06) | 0.82 (0.62-1.08) |
| Same-day appointment, % | |||
| >50 | 7,704 | ||
| About 50 | 1,607 | 1.20 (0.98-1.47) | 1.15 (0.96-1.37) |
| 20-40 | 1,275 | 1.51 (1.31-1.74) | 1.49 (1.29-1.71) |
| <20 | 1,047 | 2.01 (1.48-2.93) | 1.83 (1.34-2.50) |
| Home visits | |||
| No | 4,080 | ||
| Yes | 7,824 | 1.23 (1.11-1.36) | 0.89 (0.83-0.96) |
| Inter-visit contacts with patients | |||
| No | 1,493 | ||
| Yes | 10,427 | 0.72 (0.60-0.87) | 0.83 (0.70-0.98) |
| Information on clinical targets | |||
| No | 5,771 | ||
| Yes | 6,118 | 0.73 (0.59-0.91) | 0.80 (0.66-0.98) |
| Involved in coordinated care with hospital | |||
| No | 1,744 | ||
| Yes | 10,139 | 0.71 (0.63-0.80) | 0.84 (0.76-0.93) |
| Working with case manager | |||
| No | 2,914 | ||
| Yes, external | 2,759 | 0.92 (0.71-1.19) | 1.01 (0.81-1.25) |
| Yes, in practice | 6,261 | 0.74 (0.62-0.90) | 0.84 (0.75-0.95) |
| Delay discharge | |||
| ≤2 days | 3,757 | ||
| 2 days-2 weeks | 6,473 | 1.30 (1.15-1.47) | 1.23 (1.07-1.41) |
| 3-4 weeks | 960 | 1.92 (1.64-2.25) | 1.66 (1.39-1.98) |
| >1 month or never | 558 | 2.00 (1.79-2.23) | 1.82 (1.52-2.19) |
| Use of EHR | |||
| No | 1,621 | ||
| Yes | 10,364 | 0.78 (0.71-0.85) | 0.82 (0.68-0.98) |
| Electronic drug prescription alerts | |||
| No | 2,486 | ||
| Yes, routinely | 8,049 | 0.89 (0.73-1.07) | 1.11 (0.89-1.38) |
| Yes, occasionally | 1,343 | 1.19 (0.99-1.44) | 1.43 (1.17-1.75) |
| Consultation duration | 11,934 | 0.99 (0.97-1.01) | ... |
| Information about hospital admissions | ... | ||
| No | 7,441 | ||
| Yes | 4,375 | 0.80 (0.70-0.91) | |
| Patient satisfaction surveys | ... | ||
| No | 6,046 | ||
| Yes | 5,848 | 0.76 (0.63-0.92) | |
| Preventive targets to reach | ... | ||
| No | 8,056 | ||
| Yes | 3,732 | 0.78 (0.66-0.93) | |
| Performance comparisons | ... | ||
| No | 5,742 | ||
| Yes | 6,098 | 0.87 (0.76-1.00) | |
| Coordinated care with social workers | ... | ||
| No | 709 | ||
| Occasionally | 5,218 | 0.77 (0.67-0.90) | |
| Routinely | 6,016 | 0.62 (0.48-0.80) | |
| Contacts with home care provider | ... | ||
| Never | 352 | ||
| Occasionally | 5,710 | 0.79 (0.62-1.00) | |
| Routinely | 5,243 | 0.65 (0.49-0.87) | |
| Information on changes in patient health | ... | ||
| Never | 316 | ||
| Occasionally | 4,903 | 0.79 (0.62-0.99) | |
| Routinely | 6,117 | 0.59 (0.44-0.79) | |
| Country variance | 0.35 |
EHR = electronic health record; FTE = full time equivalent; GP = general practitioner; OR = odds ratio.
Note: The final multivariate model was built in 2 steps: first, we retained from the univariate analyses, the variables associated at a P value of .2 or less. Next, we performed a manual, backward, stepwise selection (removal of the least significant variable at each step) to obtain a final model (variables associated at a P value ≤05).