Ludovic Casanova1, Virginie Ringa2, Géraldine Bloy3, Hector Falcoff4, Laurent Rigal5. 1. Aix Marseille University, Department of general practice, Marseille. 2. Inserm, Centre for research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, Villejuif, Paris-Sud University, UMRS 1018, Villejuif, Ined, Paris. 3. LEDi, University of Burgundy, UMR CNRS 6307, Inserm U1200, Dijon. 4. Sorbonne Paris Cité, Paris Descartes University, Department of General Practice, Paris and Société de Formation Thérapeutique du Généraliste, Paris, France. 5. Inserm, Centre for research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, Villejuif, Paris-Sud University, UMRS 1018, Villejuif, Ined, Paris, Sorbonne Paris Cité, Paris Descartes University, Department of General Practice, Paris and laurent.rigal@parisdescartes.fr.
Abstract
BACKGROUND: To determine appropriate management for individual patients, GPs are supposed to use their knowledge of the patient's socio-economic circumstances. OBJECTIVE: To analyse factors associated with GPs' knowledge of these circumstances. METHODS: Observational survey of GPs who were internship supervisors in the Paris metropolitan area. Each of 52 volunteer GPs completed a self-administered questionnaire about their own characteristics and randomly selected 70 patients from their patient list. Their knowledge was analysed as the agreement between the patients' and GPs' responses to questions about the patients' socio-economic characteristics in questionnaires completed by both groups. The association between agreement and the GPs' characteristics was analysed with a multilevel model adjusted for age, sex and the duration of the GP-patient relationship. RESULTS: Agreement varied according to the socio-economic characteristics considered (from 51% to 90%) and between GPs. Globally, the GPs overestimated their patients' socio-economic level. GP characteristics associated with better agreement were sex (female), long consultations, the use of paper records or an automatic reminder system and participation in continuing medical education and in meetings to discuss difficult cases. CONCLUSION: Knowledge of some patient characteristics, such as their complementary health insurance coverage or perceived financial situation, should be improved because their overestimation may lead to care that is too expensive and thus result in the patients' abandonment of the treatment. Besides determining ways to help GPs to organize their work more effectively, it is important to study methods to help doctors identify their patients' social-economic circumstances more accurately in daily practice.
BACKGROUND: To determine appropriate management for individual patients, GPs are supposed to use their knowledge of the patient's socio-economic circumstances. OBJECTIVE: To analyse factors associated with GPs' knowledge of these circumstances. METHODS: Observational survey of GPs who were internship supervisors in the Paris metropolitan area. Each of 52 volunteer GPs completed a self-administered questionnaire about their own characteristics and randomly selected 70 patients from their patient list. Their knowledge was analysed as the agreement between the patients' and GPs' responses to questions about the patients' socio-economic characteristics in questionnaires completed by both groups. The association between agreement and the GPs' characteristics was analysed with a multilevel model adjusted for age, sex and the duration of the GP-patient relationship. RESULTS: Agreement varied according to the socio-economic characteristics considered (from 51% to 90%) and between GPs. Globally, the GPs overestimated their patients' socio-economic level. GP characteristics associated with better agreement were sex (female), long consultations, the use of paper records or an automatic reminder system and participation in continuing medical education and in meetings to discuss difficult cases. CONCLUSION: Knowledge of some patient characteristics, such as their complementary health insurance coverage or perceived financial situation, should be improved because their overestimation may lead to care that is too expensive and thus result in the patients' abandonment of the treatment. Besides determining ways to help GPs to organize their work more effectively, it is important to study methods to help doctors identify their patients' social-economic circumstances more accurately in daily practice.
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