Impact of Patient Socioeconomic Status on Physician Profiles

BACKGROUND: Patient education has been shown to affect physician performance profiles. It is not known whether census-derived measures of patient socioeconomic status (SES) show comparable effects. OBJECTIVE: The objective of this study was to compare the effects on physician profiles for patient satisfaction and physical and mental health of adjustment for patient SES derived from patient addresses geocoded to the census block group level, zip codes, and patient education. DESIGN: This was a cross-sectional survey of patients in physician practices. SETTING: Subjects came from adult primary care practices in western New York. PARTICIPANTS: A random sample of 100 primary care physicians and 50 consecutive patients seen by each physician participated in the study. MEASUREMENTS: Independent variables were census-derived (block group and zip code) patient SES and patient-reported education. The outcomes were physician ranks for patient satisfaction (Patient Satisfaction Questionnaire) and physical and mental health status (SF-12). RESULTS. In empirical Bayes models that adjusted for patient age, age squared, gender, insurance, and case mix, both the census-derived measures (block group and zip code) of SES and education had similar effects on each of the physician profiles. CONCLUSIONS. The results suggest that SES derived from either patient addresses geocoded to the census block group level or zip codes may offer a convenient alternative to individually collected SES when adjusting physician profiles for the socioeconomic characteristics of physicians' practices. The relative ease of using zip codes compared with geocoded addresses and loss of information associated with incomplete matching during geocoding suggest that zip code-derived SES may be preferable

Census · Environmental health · Family medicine · Geocoding · Geography · Matching (statistics) · Population · Socioeconomic status · Healthcare professionals’ stress and burnout · Medicine · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes

• Making psychological theory useful for implementing evidence based practice

  Susan Michie•BMJ Quality & Safety•2005

  Incluir item

• A systematic review of reasons for and against asking patients about their socioeconomic contexts

  Open Access•Andrew Moscrop, Surabhi Pancholi et al.•International Journal for Equity…•2019

  Incluir item

• Evaluating options for measurement of neighborhood socioeconomic context

  Open Access•Gina S Lovasi, Anne V Moudon et al.•Health & Place•2007

  Incluir item

• Can a publicly funded home care system successfully allocate service based on perceived need rather than socioeconomic status? A Canadian experience

  Open Access•Audrey Laporte, Ruth Croxford et al.•Health & Social Care in the…•2006

  Incluir item

• Barriers to Eligibility and Enrollment Among Older Women in a Clinical Trial on Osteoporosis

  Open Access•Christine Unson, Christine G Unson et al.•Journal of Aging and Health•2004

  Incluir item

• Culture, Race/Ethnicity and Disparities

  Margarita Alegria, Bernice A Pescosolido et al.•Handbook of the sociology of…•2011

  Incluir item

• Insurance, Acculturation, and Health Service Utilization Among Korean-Americans

  Open Access•Hosung Shin, Howin Song et al.•Journal of Immigrant Health•2005

  Incluir item

• Zip Code Caveat

  Nancy Krieger, Pamela D Waterman et al.•American Journal of Public Health•2002

  Incluir item

• Adjustment of Physician Profiles for Patient Socioeconomic Status Using Aggregate Geographic Data

  Timothy P Hofer•Medical Care•2001

  Incluir item

• Costs of Intravenous Adverse Drug Events in Academic and Nonacademic Intensive Care Units

  Teryl K Nuckols, Susan M Paddock et al.•Medical Care•2008

  Incluir item

• Differences Among the Elderly in the Treatment Costs of Colorectal Cancer

  George E Wright, William E Barlow et al.•Medical Care•2007

  Incluir item

• Massachusetts Reform and Disparities in Inpatient Care Utilization

  Amresh Hanchate, Amresh D Hanchate et al.•Medical Care•2012

  Incluir item

• Massachusetts Health Reform’s Effect on Hospitals’ Racial Mix of Patients and on Patients’ Use of Safety-net Hospitals

  Karen E Lasser, Woo-Gyeong Lee et al.•Medical Care•2016

  Incluir item

• Effects of Patient and Physician Practice Socioeconomic Status on the Health Care of Privately Insured Managed Care Patients

  Peter Franks, Kevin Fiscella et al.•Medical Care•2003

  Incluir item

• A Remarkable Legacy of Science

  William M Tierney, Morris Weinberger et al.•Medical Care•2002

  Incluir item

• Effect of Patient Socioeconomic Status on Physician Profiles for Prevention, Disease Management, and Diagnostic Testing Costs

  Peter Franks, Kevin Fiscella•Medical Care•2002

  Incluir item

• Adjusting for Patient Characteristics and Selection Effects in Assessment of Community Mental Health Centers

  Partha Deb, Ann M Holmes et al.•Medical Care•2004

  Incluir item

• Impact of Socioeconomic Adjustment on Physicians’ Relative Cost of Care

  Justin W Timbie, Peter S Hussey et al.•Medical Care•2013

  Incluir item

• Use of Census-based Aggregate Variables to Proxy for Socioeconomic Group

  A T Geronimus, John Bound•American Journal of Epidemiology•1998

  Incluir item

• Cross-Validation of Item Selection and Scoring for the SF-12 Health Survey in Nine Countries

  Open Access•Barbara Gandek, John E Ware et al.•Journal of Clinical Epidemiology•1998

  Incluir item

• League Tables and Their Limitations

  Harvey Goldstein, David J Spiegelhalter•Journal of the Royal Statistical…•1996

  Incluir item

• Defining and measuring patient satisfaction with medical care

  Open Access•John E Ware, Mary K Snyder et al.•Evaluation and Program Planning•1983

  Incluir item

• A 12-Item Short-Form Health Survey

  John E Ware, Mark Kosinski et al.•Medical Care•1996

  Incluir item

• A shorter form health survey

  Crispin Jenkinson, Richard Layte et al.•Journal of Public Health•1997

  Incluir item

• Comparison of the EQ-5D and SF-12 in an adult US sample

  Open Access•J A Johnson, Jeffrey Johnson et al.•Quality of Life Research•1998

  Incluir item

• Can Comorbidity Be Measured By Questionnaire Rather than Medical Record Review

  Jeffrey N Katz, Lily Chang et al.•Medical Care•1996

  Incluir item

• Women and social class

  Nancy Krieger•Journal of Epidemiology and…•1991

  Incluir item

• Overcoming the absence of socioeconomic data in medical records

  Nancy Krieger•American Journal of Public Health•1992

  Incluir item

• Finding Health-Related Quality of Life Outcomes Sensitive to Health-Care Organization and Delivery

  Donald L Patrick•Medical Care•1997

  Incluir item

• Applications of Health Status Assessment Measures in Clinical Practice

  Kathleen N Lohr, Mayrén Polanco Gaytán•Medical Care•1992

  Incluir item

• Impact of Sociodemographic Case Mix on the Hedis Measures of Health Plan Quality

  Alan M Zaslavsky, John N Hochheimer et al.•Medical Care•2000

  Incluir item

• Is magnitude of co-payment effect related to income? Using census data for health services research

  Open Access•Daniel C Cherkin, Louis Grothaus et al.•Social Science & Medicine•1992

  Incluir item

• Context, composition and heterogeneity

  Open Access•Craig Duncan, Kelvyn Jones et al.•Social Science & Medicine•1998

  Incluir item

• Community-Level Socioeconomic Status Effects on Adult Health

  Stéphanie Robert, Stephanie A Robert•Journal of Health and Social…•1998

  Incluir item

• Do Neighborhoods Influence Child and Adolescent Development

  Jeanne Brooks-Gunn, Greg J Duncan et al.•American Journal of Sociology•1993

  Incluir item