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Effect of part-time practice on patient outcomes
Patricia H Parkerton1, Edward H Wagner, Dean G Smith
1Department of Health Services, UCLA School of Public Health, University of California at Los Angeles, Box 91772, Los Angeles, CA 90095-1772, USA. parkert@ucla.edu
Journal of General Internal Medicine
|September 3, 2003
Summary
Primary care physicians working fewer hours showed higher quality in cancer screening and diabetic management. Reduced hours did not negatively impact patient satisfaction or costs, suggesting part-time practice is safe.
Area of Science:
- Healthcare research
- Primary care medicine
- Health services research
Background:
- Primary care physicians are reducing direct patient care hours.
- Impact of reduced physician hours on patient outcomes is unknown.
Purpose of the Study:
- To investigate if patient outcomes differ based on physicians' clinic hours.
- Assess the relationship between primary care physician work hours and quality of care.
Main Methods:
- Retrospective cross-sectional study of 194 physicians in 25 outpatient clinics (1998).
- Examined 4 aggregated outcome measures: cancer screening, diabetic management, patient satisfaction, and ambulatory costs.
- Multivariate regression controlled for physician and patient panel characteristics.
Main Results:
- Part-time physicians demonstrated higher rates of cancer screening (4%) and diabetic management (3%).
- Part-time physicians also showed higher patient satisfaction (3%), though this was not significant after controlling for confounders.
- No significant association found between physician hours and patient satisfaction or ambulatory costs.
Conclusions:
- Fewer clinical hours in primary care were linked to higher performance in specific quality measures.
- Reduced physician hours appear safe concerning patient satisfaction and healthcare costs.
- The trend towards part-time primary care practice may not compromise patient outcomes.