Patient characteristics associated with differences in patients' evaluation of their general practitioner

<p>Abstract</p> <p>Background</p> <p>Knowledge of the extent to which patient characteristics are systematically associated with variation in patient evaluations will enable us to adjust for differences between practice populations and thereby compare GPs. Whether this is appropriate depends on the purpose for which the patient evaluation was conducted. Associations between evaluations and patient characteristics may reflect gaps in the quality of care or may be due to inherent characteristics of the patients. This study aimed to determine such associations in a setting with a comprehensive list system and gate-keeping.</p> <p>Methods</p> <p>A nationwide Danish patient evaluation survey among voluntarily participating GPs using the EUROPEP questionnaire, which produced 28,260 patient evaluations (response rate 77.3%) of 365 GPs. In our analyses we compared the prevalence of positive evaluations in groups of patients.</p> <p>Results</p> <p>We found a positive GP assessment to be strongly associated with increasing patient age and increasing frequency of attendance. Patients reporting a chronic condition were more positive, whereas a low self-rated health was strongly associated with less positive scores also after adjustment. The association between patient gender and assessment was weak and inconsistent and depended on the focus. We found no association either with the patients' educational level or with the duration of listing with the GP even after adjusting for patient characteristics.</p> <p>Conclusion</p> <p>Adjustment for patient differences may produce a more fair comparison between GPs, but may also blur the assessment of GPs' ability to meet the needs of the populations actually served. On the other hand, adjusted results will enable us to describe the significance of specific patient characteristics to patients' experience of care.</p

International meta-analysis of stated preference studies of transportation noise nuisance

The final publication is available at Springer via http://dx.doi.org/10.1007/s11116-014-9527-4This paper reports the first meta-analysis and most extensive review of stated preference studies of transportation noise nuisance. The meta-analysis is based on a newly compiled data set of 258 values from 49 studies and 23 countries and spanning more than 40 years. Contrast this with the most extensive meta-analysis of the more conventional hedonic pricing approach which includes 53 noise valuations. Moreover, the sample compares favourably with the 444 observations from the very first meta-analysis of the value of travel time savings which is by far the most widely examined parameter in transport planning. A particularly significant finding of the study is that the intertemporal income elasticity is close to one, somewhat larger than the cross-sectional income elasticity typically obtained from individual studies. This demonstrates the importance of distinguishing the effects of 2 income variations that occur over time, which tend to drive policy, from variations across individuals at one point in time, and such findings are typical of those observed in other markets. Importantly, the values derived are transferable across countries and may be used to benchmark existing evidence and provide values in contexts where none exist. Other key results are that values for aircraft noise exceed those for other modes, whilst those exposed to higher noise levels and those who are highly annoyed also have higher values in line with expectations. A wide range of design effects were tested but few were significant and these included the consumer surplus measure, the representation of noise and the context