Satisfaction With Health Care Providers and Preventive Care Adherence
Bibliographic record
Abstract
BACKGROUND: Prior studies demonstrating associations between patient satisfaction with health care providers and preventive adherence were cross-sectional, limiting causal inferences. In cross-sectional and prospective analyses, we explored 3 hypotheses previously invoked to explain associations between satisfaction with providers and preventive adherence: (1) receiving preventive care increases satisfaction; (2) enhancing satisfaction increases preventive care; (3) satisfaction and adherence reflect patient characteristics, incompletely adjusted for in previous studies. METHODS: We conducted 3 sets of logistic regression analyses employing 2000-2010 Medical Expenditure Panel Survey data: 1 cross-sectional and 2 prospective (baseline preventive care/follow-up year satisfaction, and baseline satisfaction/follow-up year preventive care), each set cumulatively adjusting for patient demographics, socioeconomics, morbidity, health care access, and medical skepticism. Consumer Assessment of Health Plans Survey items measured satisfaction with care from all providers in the preceding year. Preventive care examined included influenza vaccination and colorectal cancer, Papanicolaou, mammography, and prostate-specific antigen screening. RESULTS: In cross-sectional analyses adjusted for demographics (N = 74,792), highest (vs. lowest) quartile satisfaction was associated with preventive adherence [adjusted odds ratios (95% confidence interval)]: influenza vaccination 1.14 (1.07, 1.22); colorectal cancer screening 1.08 (0.99, 1.18); Papanicolaou screening 1.14 (1.04, 1.24); mammography screening 1.20 (1.11, 1.31); prostate-specific antigen screening 1.38 (1.25, 1.52). With full adjustment, associations of satisfaction with adherence were substantially attenuated, eliminated, or reversed. Prospective analyses yielded findings similar to the cross-sectional analyses. CONCLUSIONS: Cross-sectional and prospective associations between satisfaction with providers and preventive care adherence were similarly explained by patient characteristics. The findings question previously hypothesized causal relationships between satisfaction and preventive adherence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".