Background
Methods
Participants
Ethics
Instruments
Data and variables
Variable (definition) | Gender | ||||
---|---|---|---|---|---|
Male (n = 1018) | Female (n = 1163) | p-value
1
| |||
Number | % | Number | % | ||
Characteristics of patients
| |||||
Age, years | |||||
18–39 | 18 | 1.8 | 50 | 4.3 | 0.002 |
40–59 | 274 | 27.0 | 322 | 27.8 | |
> 59 | 722 | 71.2 | 788 | 67.9 | |
Health status | |||||
Good | 603 | 60.4 | 631 | 55.4 | 0.019 |
Poor | 396 | 39.6 | 509 | 44.6 | |
Home ownership | |||||
Own home and car | 795 | 79.2 | 797 | 69.3 | <0.001 |
Own home only | 22 | 2.2 | 121 | 10.5 | |
Own car only | 136 | 13.5 | 154 | 13.4 | |
Rent and do not own a car | 51 | 5.1 | 78 | 6.8 | |
Education | |||||
Degree/Diploma | 370 | 36.6 | 356 | 30.9 | 0.006 |
Elementary/High school | 642 | 63.4 | 795 | 69.1 | |
Employment | |||||
Employed | 356 | 35.1 | 329 | 28.6 | <0.001 |
Retired | 512 | 50.5 | 507 | 44.1 | |
Unemployed2
| 145 | 14.3 | 314 | 27.3 | |
Marital status | |||||
Married (married/cohabiting) | 766 | 77.8 | 722 | 64.1 | <0.001 |
Unmarried3
| 219 | 22.2 | 405 | 35.9 | |
Disease | |||||
One condition | 571 | 56.7 | 768 | 68.3 | <0.001 |
Two or more conditions | 436 | 43.3 | 357 | 31.7 | |
Smoker | |||||
Yes | 88 | 8.8 | 123 | 10.8 | 0.127 |
No | 909 | 91.2 | 1016 | 89.2 | |
Overall PACIC score | |||||
High (above median) | 457 | 46.2 | 557 | 50.8 | 0.035 |
Low (below median) | 533 | 53.8 | 540 | 49.2 | |
Characteristics of general practitioner (GP)(n = 193)
| |||||
Gender of GP | |||||
Male (n = 121) | 863 | 84.8 | 785 | 67.5 | <0.001 |
Female (n = 72) | 155 | 15.2 | 378 | 32.5 | |
Country of graduation | |||||
Australia (n = 143) | 834 | 81.9 | 912 | 78.6 | 0.686 |
Overseas (n = 49) | 184 | 18.1 | 248 | 21.4 | |
Years in the current practice | |||||
<6 (n = 85) | 337 | 33.3 | 462 | 40.1 | 0.001 |
6–15 (n = 56) | 266 | 26.3 | 307 | 26.7 | |
> 15 (n = 47) | 408 | 40.4 | 382 | 33.2 | |
Years as a GP | |||||
< 19 (n = 77) | 288 | 28.5 | 427 | 37.3 | <0.001 |
19–24 (n = 48) | 319 | 31.6 | 366 | 32.0 | |
> 24 (n = 54) | 403 | 39.9 | 352 | 30.7 | |
Works in a small practice (1–3 GPs) (n=39) | 435 | 42.7 | 487 | 41.9 | 0.686 |
Works in a large practice (>3 GPs) (n=154) | 583 | 57.3 | 676 | 58.1 | |
Location of work | |||||
Urban (n = 101) | 503 | 49.4 | 524 | 45.1 | 0.042 |
Rural (n = 92) | 515 | 50.6 | 639 | 54.9 |
Statistical analyses
PCS-12 | MCS-12 | |||||
---|---|---|---|---|---|---|
Variable (definition) | Male | Female | Male | Female | ||
Mean (SD) | Mean (SD) | p-value
1
| Mean (SD) | Mean (SD) | p-value
1
| |
Overall score | 43.0(11.7) | 42.3(12.4) | 0.206 | 50.0(10.9) | 48.3(11.2) | 0.002 |
Characteristics of patients
| ||||||
Age, years | ||||||
18–39 | 49.3(7.7) | 46.3(11.3) | 0.246 | 46.7(10.7) | 41.9(11.9) | 0.154 |
40–59 | 46.1(10.7) | 45.9(11.9) | 0.870 | 48.2(11.0) | 45.3(11.8) | 0.005 |
> 59 | 41.6(11.8) | 40.5(12.4) | 0.106 | 50.8(10.7) | 50.0(10.4) | 0.214 |
Health status | ||||||
Good | 48.1(9.1) | 48.3(9.4) | 0.822 | 53.0(8.7) | 52.0(9.1) | 0.059 |
Poor | 35.2(10.8) | 34.5(11.6) | 0.397 | 45.4(12.2) | 43.4(11.7) | 0.025 |
Home ownership | ||||||
Own home and car | 43.8(11.4) | 44.1(12.1) | 0.605 | 50.9(10.4) | 49.3(10.7) | 0.007 |
Own home only | 38.2(11.4) | 37.9(12.1) | 0.939 | 47.9(10.8) | 47.2(11.4) | 0.820 |
Own car only | 42.4(12.1) | 39.7(12.3) | 0.081 | 47.1(11.6) | 45.7(11.0) | 0.323 |
Rent and do not own a car | 34.7(11.5) | 34.5(12.5) | 0.935 | 42.3(11.8) | 44.5(13.9) | 0.423 |
Education | ||||||
Degree/Diploma | 45.7(10.3) | 44.8(11.9) | 0.284 | 51.7(10.3) | 48.0(10.6) | <0.001 |
Elementary/High school | 41.5(12.2) | 41.2(12.5) | 0.688 | 49.2(11.1) | 48.3(11.4) | 0.199 |
Employment | ||||||
Employed | 48.0(9.2) | 48.2(10.7) | 0.785 | 49.7(9.9) | 47.1(10.9) | 0.003 |
Retired | 41.5(11.6) | 40.5(11.8) | 0.224 | 52.0(10.1) | 51.0(9.9) | 0.152 |
Unemployed2
| 35.6(11.9) | 38.9(13.2) | 0.020 | 43.7(13.3) | 45.3(12.3) | 0.248 |
Marital status | ||||||
Married (married/cohabiting) | 43.4(11.5) | 43.4(12.2) | 0.998 | 50.6(10.5) | 49.4(10.8) | 0.061 |
Unmarried3
| 41.4(12.4) | 39.9(12.6) | 0.163 | 47.6(12.1) | 46.2(11.6) | 0.225 |
Disease | ||||||
One condition | 45.1(11.6) | 43.6(12.4) | 0.035 | 50.3(10.5) | 49.0(11.0) | 0.052 |
Two or more conditions | 40.3(11.1) | 39.5(12.2) | 0.378 | 49.5(11.3) | 47.2(11.1) | 0.010 |
Smoker | ||||||
Yes | 41.3(11.8) | 41.0((12.3) | 0.850 | 48.0(11.5) | 41.9(12.1) | 0.001 |
No | 43.3(11.6) | 42.4(12.5) | 0.157 | 50.1(10.8) | 49.1(10.8) | 0.056 |
Overall PACIC score | ||||||
High (above median) | 42.6(11.7) | 41.1(12.6) | 0.070 | 50.3(10.7) | 48.4(10.6) | 0.009 |
Low (below median) | 43.3(11.7) | 43.1(12.3) | 0.813 | 49.3(11.1) | 47.6(11.6) | 0.030 |
Characteristics of general practitioner (GP)
| ||||||
Gender of GP | ||||||
Male | 42.8(11.8) |
41.1(12.5)
| 0.014 | 49.9(10.8) | 48.5(11.3) | 0.017 |
Female | 44.4(10.7) |
44.8(11.9)
| 0.716 | 50.1(11.3) | 47.8(11.0) | 0.050 |
Country of graduation | ||||||
Australia | 42.9(11.8) | 42.3(12.5) | 0.366 | 50.4(10.9) | 48.4(11.1) | 0.001 |
Overseas | 43.8(11.0) | 42.4(12.2) | 0.292 | 48.2(10.8) | 47.8(11.5) | 0.718 |
Years in the current practice | ||||||
<6 | 42.8(11.1) | 43.0(12.2) | 0.799 | 49.3(10.8) | 47.3(11.3) | 0.028 |
6–15 | 42.6(11.8) | 41.7(12.9) | 0.449 | 49.4(12.4) | 49.6(11.1) | 0.853 |
> 15 | 43.6(12.1) | 42.0(12.1) | 0.094 | 51.0(9.9) | 48.5(11.0) | 0.003 |
Years as a GP | ||||||
< 19 | 44.0(11.0) | 43.1(12.2) | 0.403 | 49.2(10.7) | 48.1(11.3) | 0.242 |
19–24 | 42.3(12.1) | 42.6(12.2) | 0.819 | 50.3(11.0) | 48.9(11.0) | 0.118 |
> 24 | 43.1(11.7) | 41.2(12.9) | 0.068 | 50.2(10.8) | 47.9(11.6) | 0.013 |
Works in a small practice (1–3 GPs) | 42.8(12.4) | 41.9(13.0) | 0.312 | 49.0(11.3) | 47.5(11.6) | 0.082 |
Works in a large practice (> 3 GPs) | 43.2(11.1) | 42.6(12.0) | 0.437 | 50.7(10.5) | 48.9(10.8) | 0.006 |
Location of work | ||||||
Urban | 43.7(11.4) | 42.2(12.0) | 0.096 | 51.2(9.9) | 48.3(11.0) | <0.001 |
Rural | 42.5(11.8) | 42.3(12.8) | 0.804 | 49.0(11.5) | 48.3(11.3) | 0.296 |
Multilevel models
Multiple imputations
Parameters (reference category) | Multilevel estimates for the main model | |||
---|---|---|---|---|
Male | Female | |||
Complete cases | Imputed full model | Complete cases | Imputed full model | |
(n = 768) | (n =1018) | (n =823) | (n =1163) | |
Fixed effects
| ||||
Intercept | 35.89 | 34.61 | 37.60 | 36.47 |
Patient characteristics
| ||||
Age, years | ||||
40-59 (18–39) | −6.18 (2.44)* | −4.43 (2.39) | −2.87 (1.92) | −1.40 (1.60) |
>59 (18–39) | −7.62 (2.47)†
| −5.82 (2.41)* | −5.75 (1.96)†
| −4.52 (1.62)†
|
Good or very good health (very bad, bad or fair health) | 11.11 (0.69)‡
| 10.92 (0.75)‡
| 12.93 (0.70)‡
| 12.37 (0.67)‡
|
Own home & car (rented & don’t own a car) | 2.14 (1.72) | 2.79 (1.52) | 4.07 (1.45)†
| 4.23 (1.38)†
|
Own home only (rented & don’t own car) | −0.83 (2.88) | −0.38 (2.98) | 1.56 (1.69) | 2.03 (1.65) |
Own car only (rented & don’t own a car) | 1.74 (1.83) | 2.57 (1.72) | 1.13 (1.63) | 1.32 (1.57) |
College / university (elementary / high school) | 1.68 (0.73)* | 1.65 (0.70)* | −0.19 (0.78) | 0.05 (0.75) |
Employed patients (unemployed1) | 7.66 (1.15)‡
| 7.29 (1.04)‡
| 4.22 (0.99)‡
| 4.05 (1.08)‡
|
Retired patients (unemployed1) | 3.90 (1.11)‡
| 3.86 (1.03)‡
| 0.09 (0.87) | 0.08 (0.91) |
Married/cohabiting (single/separated/divorced/widowed) | 0.36 (0.88) | 0.03 (0.87) | 0.75 (0.75) | 1.20 (0.72) |
Two or more conditions (one condition) | −2.20 (0.68)†
| −2.57 (0.69)‡
| −1.79 (0.74)* | −1.56 (0.72)* |
Smoker (non-smoker) | −0.54 (1.25) | −0.43 (1.23) | 0.67 (1.14) | 0.67 (1.13) |
Overall satisfaction with care | 0.07 (0.32) | 0.13 (0.30) | −0.84 (0.33)* | −0.78 (0.38)* |
General Practitioner characteristics
| ||||
Female (Male) | 1.52 (0.98) | 1.48 (1.04) | 2.19 (0.80)†
| 1.59 (0.78)* |
Overseas qualified (qualified in Australia) | 1.39 (0.88) | 1.37 (0.99) | 0.47 (0.85) | −0.09 (0.83) |
Years in the current practice 6–15 (< 6) | −0.27 (0.91) | −0.44 (0.93) | −0.80 (0.89) | −0.58 (0.85) |
> 15 (< 6) | 0.02 (0.90) | 0.08 (0.92) | 1.05 (0.95) | 1.20 (1.05) |
Years as a GP | ||||
19–24 (< 19) | −0.80 (0.95) | −1.04 (0.96) | 0.62 (0.89) | −0.43 (0.87) |
> 24 (< 19) | 0.61 (0.99) | −0.04 (1.0) | −0.57 (1.00) | −0.91 (1.01) |
Size 1–3 GPs in the practice (4 or more GPs) | 1.04 (0.72) | 0.82 (0.81) | −1.54 (0.75)* | −1.10 (0.72) |
Urban practice (Rural practice) | −0.18 (0.70) | −0.09 (0.69) | −0.27 (0.76) | −0.05 (0.74) |
Random effects
| ||||
Variance between general practitioners (standard errors) | 0.00 (0.00) | 1.15 (1.60) | 0.00 (0.00) | 0.93 (1.56) |
% variance explained | 100 | 70.2 | 100 | 90.3 |
Variance between patients (standard errors) | 81.84 (4.18)‡
| 84.66 (4.81)‡
| 91.49 (4.51)‡
| 93.29 (5.21)‡
|
% variance explained | 38.6 | 36.3 | 37.4 | 36.3 |
Parameters (reference category) | Multilevel estimates for the main model | |||
---|---|---|---|---|
Male | Female | |||
Complete cases | Imputed full model | Complete cases | Imputed full model | |
(n = 768) | (n =1018) | (n =823) | (n =1163) | |
Fixed effects
| ||||
Intercept | 35.52 | 35.09 | 32.80 | 34.16 |
Patient characteristics
| ||||
Age, years | ||||
40-59 (18–39) | 0.48 (2.64) | 0.31 (2.49) | 2.83 (1.96) | 2.42 (1.57) |
>59 (18–39) | 1.89 (2.68) | 1.68 (2.51) | 6.33 (1.99)†
| 5.62 (1.64)‡
|
Good or very good health (very bad, bad or fair health) | 6.92 (0.75)‡
| 6.84 (0.79)‡
| 7.31 (0.71)‡
| 7.33 (0.62)‡
|
Own home & car (rented & don’t own car) | 5.04 (1.87)†
| 3.42 (1.71)* | 1.37 (1.48) | 1.50 (1.29) |
Own home only (rented & don’t own a car) | 3.24 (3.12) | 0.30 (2.77) | 0.47 (1.72) | 0.27 (1.61) |
Own car only (rented & don’t own car) | 3.04 (1.98) | 1.55 (1.93) | 0.67 (1.66) | 0.67 (1.43) |
College / university (elementary / high school) | 0.78 (0.79) | 0.65 (0.78) | 0.07 (0.79) | 0.00 (0.72) |
Employed patients (unemployed1) | 2.95 (1.24)* | 3.40 (1.18)†
| 1.42 (1.01) | 1.16 (1.03) |
Retired patients (unemployed1) | 4.95 (1.20)‡
| 5.43 (1.10)‡
| 2.62 (0.89)†
| 2.86 (0.87)†
|
Married/cohabiting (single/separated/divorced/widowed) | 0.91(0.95) | 0.96 (1.03) | 2.29 (0.77)†
| 2.43 (0.73)‡
|
Two or more conditions (one condition) | 0.11 (0.74) | −0.05 (0.77) | −0.96 (0.76) | −1.56 (0.73)* |
Smoker (non-smoker) | 1.62 (1.35) | 1.16 (1.39) | −4.20 (1.17)‡
| −3.99 (1.08)‡
|
Overall satisfaction with care | 0.60 (0.35) | 0.56 (0.36) | 1.04 (0.34)†
| 0.84 (0.34)* |
General Practitioner characteristics
| ||||
Female (Male) | 0.55 (1.06) | 0.41 (1.04) | −1.25 (0.81) | −0.74 (0.75) |
Overseas qualified (qualified in Australia) | −1.87 (0.96) | −1.73 (0.98) | −0.28 (0.86) | 0.02 (0.85) |
Years in the current practice | ||||
6–15 (< 6) | −1.32 (0.99) | −0.82 (0.97) | 0.66 (0.91) | 0.90 (0.88) |
> 15 (< 6) | −0.04 (0.97) | 0.02 (0.99) | 0.18 (0.97) | 0.36 (1.02) |
Years as a GP | ||||
19–24 (< 19) | 0.35 (1.03) | 0.51 (1.04) | 0.88 (0.91) | 0.49 (0.87) |
> 24 (< 19) | 0.58 (1.07) | 0.44 (1.13) | 0.23 (1.02) | −0.52 (1.04) |
Size 1–3 GPs in the practice (4 or more GPs) | −0.84 (0.78) | −0.79 (0.80) | −0.63 (0.77) | −0.69 (0.69) |
Urban practice (Rural practice) | 0.87 (0.76) | 0.93 (0.74) | −0.34 (0.78) | −0.32 (0.73) |
Random effects
| ||||
Variance between general practitioners (standard errors) | 0.00 (0.00) | 0.92 (1.53) | 0.00 (0.00) | 0.30 (1.01) |
% variance explained | 100 | 84.3 | 100 | 88.1 |
Variance between patients (standard errors) | 96.08 (4.90)‡
| 97.67 (5.35)‡
| 95.10 (4.69)‡
| 96.36 (4.43)‡
|
% variance explained | 16.6 | 16.4 | 22.9 | 22.3 |