Article Figures & Data
Tables
- Table 1.
Baseline Characteristics of Family Medicine PDs (Responses by US Region*, Collected between February 2015 and March 2015)
Characteristic Overall (N = 273) Northeast (N = 52) Midwest (N = 58) South (N = 96) West (N = 67) Residency Program Context Size of community (population) <150,000 (n) 123 39 25 44 15 150,000–500,000 (n) 64 7 17 20 20 >500,000 (n) 86 6 16 32 32 Proportion of community-based programs (%) 78 84 73 77 82 Average age of program (years) 32.7 35.2 33.9 33.8 28.2 Proportion of programs with > 25% graduates from non-US medical school (%) 48 63 46 55 28 Residency PD characteristics Male (%) 64 61 71 64 60 Tenure (years) 6.3 7.4 6 6.1 6 PD attitudes toward statements pertaining to HCV treatment-related ethical issues (Agree responses, %) “Treatment should be an option for all patients with HCV regardless of cost” 70 65 74 69 72 “State Medicaid programs' decision to limit access to HCV treatment will worsen racial and ethnic disparities in health care” 70 63 72 74 69 “It is unethical to deny access to treatment based on the patient's past or current behavior” 47 44 50 52 39 “It is unethical that a potentially lifesaving medicine is so highly priced” 69 52 79 70 69 “Patients with active substance abuse should be offered HCV treatment” 38 42 38 42 28 “Benefit outweighs cost only for patients with advanced liver disease” 35 38 26 42 30 Moral distress (To what extent do you experience moral distress when you are unable to offer hepatitis C treatment to patients due to them not meeting current eligibility criteria?) Moral distress (high level) 61 60 60 57 69 ↵* US regions as classified by the Center for Disease Control (CDC), https://www.cdc.gov/std/stats11/census.htm.
PD, program director.
HCV, Hepatitis C virus.
Variable Mean SD 1 2 3 4 5 6 7 8 1 Program Director Tenure 6.05 5.73 1 2 Age of Program 32.31 14.31 0.095 1 3 Gender 1.63 0.49 −0.002 0.044 1 4 Moral Distress 4.59 1.93 −0.052 0.101 −0.155* 1 5 Belief in Worsening Disparity 4.21 1.43 0.016 0.022 −0.264† 0.402† 1 6 Intent to offer treatment to active substance users 3.08 1.48 0.068 0.148* −0.094 0.177† 0.309† 1 7 Intent to offer treatment regardless of past or current behaviors 3.34 1.53 0.018 0.08 −0.254† 0.337† 0.427† 0.531† 1 8 Belief that it is unethical for life saving medicine to be so expensive 4.11 1.56 0.073 −0.026 −0.276† 0.419† 0.477† 0.212† 0.374† 1 9 Belief in Treatment regardless of cost 4.07 1.4 −0.042 0.134* −0.174† 0.362† 0.413† 0.445† 0.556† 0.280† - Table 3.
Association of Moral Distress (Independent Variable) with Program Director Beliefs
Belief Statement Beta Weight 1 Belief in offering treatment regardless of Cost 0.36* 2 Belief that Benefit Outweighs Cost Only for Advanced Liver Disease −0.017 3 Belief that it is unethical to deny treatment Based on Past Behavior 0.333* 4 Belief that substance abusers should be offered HCV Treatment 0.177* 5 Belief that it is unethical for HCV Medicine to be so prohibitively expensive 0.415* 6 Medicaid policy limiting treatment will worsen racial and ethnic disparity 0.397* ↵* P < .001.
HCV, Hepatitis C virus.
