Study finds that patient satisfaction scores are related to factors other than health. Linking these scores to physician pay could lead to lower compensation for young female doctors and incentivize doctors to prescribe controlled substances at higher rates.
This legacy brief is available as a downloadable PDF.
Background: Assessing patient experiences with healthcare and publicly reporting this information is increasingly prevalent. Patients use this data when reviewing physicians and hospital systems. Measurements of patient satisfaction are increasingly integrated into payment policies from insurance companies. Objective: This study analyzes (1) the relationship of physician characteristics and treatment modalities to patient satisfaction scores among primary care physicians and (2) the relationship of higher patient satisfaction scores to compliance with health maintenance objectives like mammography and colonoscopy. Main Measures: CAHPS survey as administered by Press Ganey for Main Line Health Care physicians in suburban Philadelphia. Survey data obtained on 115 physicians over 345 "doctor-years." Patient data identified by ICD9/10 codes linked to chief complaints of (1) upper respiratory illness (2) back pain and (3) fatigue, depression and anxiety. Treatment modalities groupings include (a) prescriptions for antibiotics (b) prescriptions for narcotics, (c) prescriptions for stimulants, (d) prescriptions for benzodiazepines, and (e) orders for radiologic imaging. Rates of colonoscopies and mammograms per provider were obtained for the year 2017. Key Results: Providers in practice for longer periods of time received higher top box scores. There is a significant difference in top box scores for female physicians years 0-3 and 4-9 when compared to male physicians in practice more than 10 years. There is a significant relationship between top box scores and the physician's rate of writing prescriptions for benzodiazepines, narcotics and stimulants. There is a positive correlation between top box score and compliance with mammography and colonoscopy screenings. Conclusions: Press Ganey top box score correlates with physician gender, years of experience, and certain treatment modalities. There is a correlation between high patient satisfaction scores and rate of mammography and colonoscopy compliance. Our results do not imply a causative relationship but may be suggestive that one exists.
PWBM’s Jon Huntley and Richard Prisinzano discussed how the financing of a federal infrastructure plan influences its effect on economic growth. Even though infrastructure investments increase productivity, plans that are deficit-financed can reduce GDP relative to current policy.
We estimate that a one-year “payroll tax holiday” would cost the federal government between $141 and $151 billion over the standard budget window and increase GDP by 0.3 percent in 2020, with effects eventually turning slightly negative over time with higher deficits.
PWBM introduces a new measure of distribution that corrects numerous deficiencies in existing distributional measures that are commonly used to evaluate policy analysis.
Using PWBM’s new dynamic distributional analysis, we find that the Social Security 2100 Act benefits wealthy, retired households at the expense of young, high-income households.
