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Understanding high and low patient experience scores in primary care: analysis of patients' survey data for general practices and individual doctors.

Roberts MJ, Campbell JL, Abel GA, Davey AF, Elmore NL, Maramba I, Carter M, Elliott MN, Roland MO, Burt JA - BMJ (2014)

Bottom Line: Practice level surveys may be better used to "screen" for concerns about performance that require an individual level survey.Higher scoring practices are unlikely to include lower scoring doctors.However, lower scoring practices require further investigation at the level of the individual doctor to distinguish higher and lower scoring general practitioners.

View Article: PubMed Central - PubMed

Affiliation: University of Exeter Medical School, St Lukes Campus, Exeter EX1 2LU, UK.

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Related in: MedlinePlus

Fig 1 Mean communication score (best estimate) by practice and doctor. Practices (n=25) are sorted by their mean communication score. Horizontal shading serves only as visual separation of results for different practices. Reliability calculations using variance components showed that achieving acceptable reliability (>0.7) for general practitioners’ adjusted mean communication scores with 27 patients’ scores and good reliability (>0.8) with 46 patients’ scores per doctor is feasible (see appendix). All but 10 of the 105 participating doctors had more than 46 scores; two received less than 27 scores (mean 71 scores per doctor). Data for these doctors was retained in the subsequent modelling, as use of best linear unbiased predictors to estimate doctors’ mean scores has a “conservative” effect. Where sample sizes are smaller, estimated mean scores are drawn closer to practice mean
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fig1: Fig 1 Mean communication score (best estimate) by practice and doctor. Practices (n=25) are sorted by their mean communication score. Horizontal shading serves only as visual separation of results for different practices. Reliability calculations using variance components showed that achieving acceptable reliability (>0.7) for general practitioners’ adjusted mean communication scores with 27 patients’ scores and good reliability (>0.8) with 46 patients’ scores per doctor is feasible (see appendix). All but 10 of the 105 participating doctors had more than 46 scores; two received less than 27 scores (mean 71 scores per doctor). Data for these doctors was retained in the subsequent modelling, as use of best linear unbiased predictors to estimate doctors’ mean scores has a “conservative” effect. Where sample sizes are smaller, estimated mean scores are drawn closer to practice mean

Mentions: Figure 1 shows the estimated mean communication scores for individual doctors and for practices as a whole. It illustrates the extent to which the variation in mean communication scores between individual doctors (within practices) was greater than the variation between practices and suggests that within practice variability in doctors’ scores was greater in the lower scoring practices. Further analysis confirmed this: the within practice standard deviation of general practitioners’ mean communication scores was negatively correlated with the practice’s mean communication score (Pearson’s r=−0.505; P=0.010). Figure 2 shows the adjusted doctor level and practice level mean scores for “cleanliness of the practice buildings” and highlights, in contrast to figure 1, the minimal within practice variability between general practitioners for this non-doctor-specific measure.


Understanding high and low patient experience scores in primary care: analysis of patients' survey data for general practices and individual doctors.

Roberts MJ, Campbell JL, Abel GA, Davey AF, Elmore NL, Maramba I, Carter M, Elliott MN, Roland MO, Burt JA - BMJ (2014)

Fig 1 Mean communication score (best estimate) by practice and doctor. Practices (n=25) are sorted by their mean communication score. Horizontal shading serves only as visual separation of results for different practices. Reliability calculations using variance components showed that achieving acceptable reliability (>0.7) for general practitioners’ adjusted mean communication scores with 27 patients’ scores and good reliability (>0.8) with 46 patients’ scores per doctor is feasible (see appendix). All but 10 of the 105 participating doctors had more than 46 scores; two received less than 27 scores (mean 71 scores per doctor). Data for these doctors was retained in the subsequent modelling, as use of best linear unbiased predictors to estimate doctors’ mean scores has a “conservative” effect. Where sample sizes are smaller, estimated mean scores are drawn closer to practice mean
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230029&req=5

fig1: Fig 1 Mean communication score (best estimate) by practice and doctor. Practices (n=25) are sorted by their mean communication score. Horizontal shading serves only as visual separation of results for different practices. Reliability calculations using variance components showed that achieving acceptable reliability (>0.7) for general practitioners’ adjusted mean communication scores with 27 patients’ scores and good reliability (>0.8) with 46 patients’ scores per doctor is feasible (see appendix). All but 10 of the 105 participating doctors had more than 46 scores; two received less than 27 scores (mean 71 scores per doctor). Data for these doctors was retained in the subsequent modelling, as use of best linear unbiased predictors to estimate doctors’ mean scores has a “conservative” effect. Where sample sizes are smaller, estimated mean scores are drawn closer to practice mean
Mentions: Figure 1 shows the estimated mean communication scores for individual doctors and for practices as a whole. It illustrates the extent to which the variation in mean communication scores between individual doctors (within practices) was greater than the variation between practices and suggests that within practice variability in doctors’ scores was greater in the lower scoring practices. Further analysis confirmed this: the within practice standard deviation of general practitioners’ mean communication scores was negatively correlated with the practice’s mean communication score (Pearson’s r=−0.505; P=0.010). Figure 2 shows the adjusted doctor level and practice level mean scores for “cleanliness of the practice buildings” and highlights, in contrast to figure 1, the minimal within practice variability between general practitioners for this non-doctor-specific measure.

Bottom Line: Practice level surveys may be better used to "screen" for concerns about performance that require an individual level survey.Higher scoring practices are unlikely to include lower scoring doctors.However, lower scoring practices require further investigation at the level of the individual doctor to distinguish higher and lower scoring general practitioners.

View Article: PubMed Central - PubMed

Affiliation: University of Exeter Medical School, St Lukes Campus, Exeter EX1 2LU, UK.

Show MeSH
Related in: MedlinePlus