Effects of Physician-Related Factors on Adult Asthma Care, Health Status, and Quality of Life

Details

• Personal Author:
  Blanc PD ; Earnest, Gary S. ; Eisner MD ; Katz PP ; San Pedro M ; Trupin L ; Yelin EH
• Description:
  To study the association of physician characteristics, the characteristics of their practice settings, patient mix, and reported frequency of prescribing asthma medication with patients' health status and health-related quality of life in asthma. We conducted a mail-back survey of physicians (n = 147) that included demographic characteristics, practice and training characteristics, and reported prescribing frequencies for common asthma treatments. We also conducted structured telephone interviews with 317 of their patients, assessing demographic characteristics, health status (as measured by the Short Form-12 [SF-12] physical component score), and asthma-specific quality of life (as measured by the Marks questionnaire). In adjusted analyses, pulmonary specialists were more likely to report using leukotriene modifiers (odds ratio [OR] = 4.7; 95% confidence interval [CI]: 1.2 to 18) and theophylline (OR = 3.0; 95% CI: 1.0 to 9.0) in adult patients with asthma. Working in a practice of >75% health maintenance organization (HMO)- or preferred provider organization (PPO)-insured patients was associated with a lower likelihood of prescribing leukotriene modifiers (OR = 0.1; 95% CI: 0.01 to 0.5). Adjusting for patient demographic characteristics and steroid dependence, physician prescribing tendencies were not associated with patients' perceived health status or quality of life. Although an HMO- or PPO-predominant practice was associated with better physical health status (mean difference in SF-12 physical component score, 3.1; 95% CI: 0.05 to 6.2; P = 0.05), there was no statistical association with quality of life. The characteristics of physicians, their practices, and the asthma medication prescribing strategies that they adopt are not strongly associated with patients' perceived outcomes. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Delivery Of Health Care Demography Health Personnel Occupational Health Safety Staff Development
• Keywords:
  Bronchial-asthma Demographic-characteristics Health-care Health-care-personnel Medical-care Medical-personnel Medical-treatment Physicians Training
• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  114
• Issue:
  7
• NIOSHTIC Number:
  nn:20029148
• Citation:
  Am J Med 2003 May; 114(7):581-587
• Contact Point Address:
  Paul D. Blanc, MD, MSPH, Department of Medicine, University of California, San Francisco, 350 Parnassus Avenue, Suite 609, Box 0924, , San Francisco, California, , USA 94117
• Email:
  blancp@itsa.ucsf.edu
• Federal Fiscal Year:
  2003
• NORA Priority Area:
  Research Tools and Approaches: Social and Economic Consequences
• Performing Organization:
  University of California, Cardiovascular Research Institute, San Francisco, California
• Peer Reviewed:
  True
• Start Date:
  19970930
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20010929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9c6d5934c31e99af45a9cd99b2afbd1a5fb353ec8a1454eb6afa22327453bd8ff9a557111197a1a84189de0fa7ef383c57a055509b229de5e5a69337ea49f52d
• Download URL:
  https://stacks.cdc.gov/view/cdc/190200/cdc_190200_DS1.pdf
• File Type:
  [PDF - 109.84 KB ]