Managed Care and Physician Satisfaction

产品说明： 背景：两个研究主题将通过分析解决， 来自我们之前的医生转诊研究（AHRQ HS 06833）的次要数据。在 市场竞争和管理式医疗的时代，越来越多的初级 医生对他们的工作不满意。我们对此知之甚少 主治医生的不满意是否会损害医患关系 关系和健康结果。第二，更多管理计划中的患者 对他们的主治医生不太满意，但对他们的健康状况知之甚少。 管理式护理和患者对专家和健康结果的满意度。 目的：目的是：1）确定管理式护理之间的关联， 主治医师满意度，患者-主治医师关系， 和健康结果;和2）确定管理式护理之间的关联， 患者对专家的满意度和健康结果。 设计：前瞻性队列研究，在261名初级医生的办公室， 西雅图的私人诊所17187例患者在等待期接受筛查 2,850例患者分为三组：（1）疼痛患者 （2）单纯抑郁症患者（n=575; （3）伴有疼痛和抑郁症状的患者（n=761; 27%）。 患者（n=2004）在1个月、3个月和6个月时完成随访调查。 大约95%的参与医生和96%的办公室经理完成了 自填问卷。 医生满意度：医生工作满意度指数，医生推荐 满意度指数 患者-医生关系：主治医生的患者评分，患者-主治医生 医生关系指数、主治医生连续性、患者 专家评分。 管理式护理的措施：对于每一个病人，病人的管理程度？S 健康计划，计划福利指数，是否存在心理健康 对病人进行管理式护理的强度初级保健办公室， 医生的经济激励，以及医生是否阅读或使用AHCPR 背痛和抑郁症的临床指南。 结果测量：对于疼痛患者，疼痛困扰，疼痛 干扰、活动受限天数和患者对主要 医生。对于有抑郁症状的患者，结果是症状 抑郁、活动受限天数和患者满意度检查表 与主治医师。 数据分析：多元回归分析，以确定目标中的关联 1和2.

DESCRIPTION: Background: Two research topics will be addressed through analysis of secondary data from our previous Physician Referral Study (AHRQ HS06833). In the era of market competition and managed care, more and more primary physicians are dissatisfied with their jobs. We know very little about whether primary physician dissatisfaction is harming patient-physician relationships and health outcomes. Second, patients in more managed plans are less satisfied with their primary physicians, but far less is known about managed care and patient satisfaction with specialists and health outcomes. Aims: Aims are: 1) to determine the associations between managed care, primary physician satisfaction, the patient-primary physician relationship, and health outcomes; and 2) to determine the association between managed care, patient satisfaction with specialists, and health outcomes. Design: Prospective cohort study in offices of 261 primary physicians in private practice in Seattle. Patients (n=l7,187) were screened in waiting rooms, enrolling 2,850 patients in three groups: (1) patients with pain only (n=l, 5 14; 53%); (2) patients with depressive symptoms only (n=575; 20%); and (3) patients with pain and depressive symptoms (n=761; 27%). Patients (n=2004)completed follow-up surveys at one, three, and six months. About 95% of participating physicians and 96% of office managers completed self-administered questionnaires. Physician Satisfaction: Physician job satisfaction index, physician referral satisfaction index. Patient-Physician Relationship: Patient rating of primary physician, patient-primary physician relationship index, primary physician continuity, patient rating of specialists. Measures of Managed Care: For each patient, the managed-ness of the patient?s health plan, plan benefit indexes, presence or absence of a mental health carve-out, intensity of managed care in the patient?s primary care office, physician financial incentives, and whether the physician read or used AHCPR clinical guidelines for back pain and depression. Outcome Measurements: For pain patients, pain bothersomeness, pain interference, restricted activity days, and patient satisfaction with primary physician. For patients with depressive symptoms, outcomes were the Symptom Checklist for Depression, restricted activity days, and patient satisfaction with primary physician. Data Analysis: Multiple regression analysis to determine associations in Aims 1 and 2.