Article Figures & Data
Figures
- Figure 1.
Percentage of family medicine physicians applying for continuous certification with the American Board of Family Medicine in 2016 reporting burn out (n = 351), by level of clinic capacity to address patient's social needs (clinic social determinants of health [SDH] capacity), stratified by vulnerable patient population (z statistic, −0.55, P = .29).
Tables
- Table 1.
Single-Item Burnout Question and Response Options from the 2016 American Board of Family Medicine Certification Practice Demographic Questionnaire, Dichotomized to Indicate Primary Reported Outcome of Burnout Versus Not Burned Out
Question Stem Using Your Own Definition of Burnout, Select an Answer: Responses Classified as Not Burned Out 1. I enjoy my work. I have no symptoms of burnout. 2. I am under stress, and don't always have as much energy as I did, but I don't feel burned out. Responses Classified as Burned Out 3. I am definitely burning out and have 1 or more symptoms of burnout, e.g. emotional exhaustion. 4. The symptoms of burnout that I'm experiencing won't go away. I think about work frustrations a lot. 5. I feel completely burned out. I am at the point where I may need to seek help. - Table 2.
Respondent-Reported Physician and Practice Site Characteristics by Burnout and Perceived Clinic Social Determinants of Health Capacity Among 1298 Family Physicians Applying for Continuous Certification with the American Board of Family Medicine in 2016*
Variable Total (N = 1298) N (%) Burnout Clinic SDH Capacity Burned Out (N = 481) N (%) Not Burned Out (N = 1444) N (%) P Value High SDH Capacity (N = 589) N (%) Not High SDH Capacity (N = 709) N (%) P Value Age (years) ≤45 336 (25.9) 103 (29.3) 233 (24.6) 168 (23.7) 168 (28.5) 46–55 518 (39.9) 141 (40.2) 377 (39.8) 232 (40.3) 286 (39.4) ≥56 444 (34.2) 107 (30.5) 337 (35.6) .12 189 (36.0) 255 (32.1) .11 Sex† Male 573 (44.1) 175 (49.9) 398 (42.0) 264 (44.8) 325 (43.6) Female 725 (55.9) 176 (50.1) 549 (58.0) .012‡ 325 (55.2) 400 (56.4) .65 Years in Practice ≤13 3137 (32.7) 120 (34.2) 305 (32.2) 223 (37.9) 202 (28.5) 14–21 2989 (32.1) 120 (34.2) 297 (31.4) 185 (31.4) 232 (32.7) ≥22 3449 (35.1) 111 (31.6) 345 (36.4) .27 181 (30.7) 275 (38.8) .0010‡ Race White 931 (71.73) 265 (75.5) 666 (70.3) 386 (65.5) 545 (76.9) Non-white 367 (28.3) 86 (24.5) 281 (29.7) .066 203 (34.5) 164 (23.1) <.0001‡ Ethnicity Hispanic 78 (6.01) 13 (3.7) 65 (6.9) 40 (6.8) 38 (5.4) Non-Hispanic 1220 (94.0) 338 (96.3) 882 (93.1) .033† 549 (93.2) 671 (94.6) .28 % Direct patient care: ≤50% 139 (10.7) 33 (9.4) 106 (11.2) 71 (12.1) 68 (9.6) 51%–79% 91 (7.0) 31 (8.8) 60 (6.3) 42 (7.13) 49 (6.9) ≥80% 1068 (82.3) 287 (81.8) 781 (82.5) .22 476 (80.8) 592 (83.5) .35 Workload control Poor 74 (5.7) 58 (16.5) 16 (1.7) 35 (5.9) 39 (5.5) Marginal 295 (22.7) 159 (45.3) 136 (14.4) 108 (18.3) 187 (26.4) Satisfactory 485 (37.4) 104 (29.6) 381 (40.2) 212 (36.0) 273 (38.5) Good 349 (26.9) 26 (7.4) 323 (34.1) 180 (30.6) 169 (23.8) Optimal 95 (7.3) 4 (1.1) 91 (9.6) <.0001‡ 54 (9.17) 41 (5.8) <.0001‡ Team efficiency Poor/Marginal 104 (8.0) 62 (17.7) 42 (4.4) 33 (5.6) 71 (10.0) Satisfactory 306 (23.6) 114 (32.5) 192 (20.3) 106 (18.0) 200 (28.2) Good 712 (54.9) 151 (43.0) 561 (59.2) 353 (59.9) 359 (50.6) Optimal 176 (13.6) 24 (6.84) 152 (16.1) <.0001‡ 97 (16.5) 79 (11.1) <.0001‡ Home EHR time Excessive 284 (21.9) 141 (40.2) 143 (15.1) 99 (16.8) 185 (26.1) Moderate 385 (29.7) 103 (29.3) 282 (29.8) 187 (31.8) 198 (27.9) Satisfactory 225 (17.3) 33 (9.4) 192 (20.3) 111 (18.9) 114 (16.1) Modest 170 (13.1) 32 (9.1) 138 (14.6) 82 (13.9) 88 (12.4) Minimal/None 234 (18.0) 42 (12.0) 192 (20.3) <.0001‡ 110 (18.7) 124 (17.5) .0020‡ EHR proficiency Poor/Marginal 79 (6.1) 31 (8.8) 48 (5.1) 29 (4.9) 50 (7.1) Satisfactory 336 (25.9) 87 (24.8) 249 (26.3) 132 (22.4) 204 (28.8) Good 653 (50.3) 176 (50.1) 477 (50.4) 310 (52.6) 343 (48.4) Optimal 230 (17.7) 57 (16.2) 173 (18.3) .079 118 (20.0) 112 (15.8) .0080‡ Primary practice ownership Private 767 (59.1) 201 (57.3) 566 (59.8) 304 (51.6) 463 (65.3) Hospital or HMO based 309 (23.8) 84 (23.9) 225 (23.8) 142 (24.1) 167 (23.6) FQHC and similar 136 (10.5) 40 (11.4) 96 (10.1) 81 (13.8) 55 (7.8) Other 86 (6.6) 26 (7.4) 60 (6.3) .78 62 (10.5) 24 (3.4) <.0001‡ Pharmacist on staff 255 (19.7) 75 (21.4) 180 (19.0) .34 175 (29.7) 80 (11.3) <.0001‡ Social work on staff 241 (18.6) 67 (19.1) 174 (18.4) .77 173 (29.4) 68 (9.6) <.0001‡ Behavior specialist on staff 300 (23.1) 92 (26.2) 208 (22.0) .11 191 (32.4) 109 (15.4) <.0001‡ Psychiatrist on staff 142 (10.9) 44 (12.5) 98 (10.4) .26 100 (45.4) 42 (5.9) <.0001‡ PCMH stage Not applying 435 (33.5) 113 (32.2) 322 (34.0) 171 (29.0) 264 (37.2) Applying 299 (23.0) 80 (22.8) 219 (23.1) 110 (18.7) 189 (26.7) Recognized 564 (43.5) 158 (45.0) 406 (42.9) .77 308 (52.3) 256 (36.1) <.0001‡ Vulnerable patient population† <10% 395 (30.4) 93 (26.5) 302 (31.9) 168 (28.5) 227 (32.0) 10%–19% 343 (26.4) 101 (28.8) 242 (25.6) 137 (23.3) 206 (29.1) ≥20% 560 (43.1) 157 (44.7) 403 (42.6) .16 284 (48.2) 276 (38.9) .0030‡ ↵* See Appendix Table 1 for full results of respondent characteristics.
↵† P < .05 for differences between full sample and study sample.
↵‡ P < .05.
EHR, electronic health record; HMO, health maintenance organization; FQHC, federally qualified health center; SDH, social determinants of health; PCMH, patient-centered medical home.
- Table 3.
Unadjusted and Adjusted Association between Clinic Social Determinants of Health Capacity and Self-Reported Burnout among 1298 Family Physicians Applying for Continuous Certification with the American Board of Family Medicine in 2016*
Perceived Clinic SDH Capacity Total Family Physicians Bivariate: Self-Reported Burnout n/N = 351/1298 (27.0%) Multivariable Model 1:†Self-Reported Burnout Multivariable Model 2:‡ Self-Reported Burnout N = 1298 % OR 95% CI OR 95% CI OR 95% CI Low (<6) 709 54.6 Ref Ref Ref Ref Ref Ref High (>6) 589 45.4 0.58§ 0.45–0.74 0.71§ 0.52–0.98 0.66§ 0.47–0.91 ↵* See Appendix Table 2 for full results of regression models.
↵† Variables controlled for include % direct patient care, control of workload, team work efficiency EHR time at home, EHR proficiency, stage of PCMH, years in practice, sex, race, ethnicity, and % vulnerable patient population.
↵‡ Variables controlled for include variables in model 1, in addition to practice size, practice ownership, medical school faculty, residency faculty, presence of ancillary staff (pharmacist, social worker, behavior specialist, psychologist), and employment type.
↵§ P < .05.
SDH, social determinants of health; OR, odds ratio; CI, confidence interval; Ref, reference.
- Table 4.
Bivariate and Multivariable Logistic Analyses between Practice and Physician-Level Characteristics and Perceived Clinic Capacity to Address Patient's Social Needs Among 1298 Family Physicians Applying for Continuous Certification with the American Board of Family Medicine in 2016*
Variable Total Family Physicians Bivariate: High Perceived Clinic Capacity Clinic Capacity, n/N = 589/1298 (45.4%) Multivariable:† High Perceived, n/N = 589/1298 (45.4%) N = 1298 % OR 95% CI OR 95% CI Practice-level characteristics Stage of PCMH Not applying 435 33.5 Ref Ref Ref Ref Applying 299 23.0 0.90 0.66–1.22 1.00 0.72–1.37 Recognized 564 43.5 1.86‡ 1.44–2.39 1.65‡ 1.34–2.21 Practice size Solo 184 14.2 Ref Ref Ref Ref Small (2–5 clinicians) 439 33.8 0.97 0.68–1.34 0.89 0.62–1.36 Medium (6–20 clinicians) 452 34.8 1.40 0.99–1.99 1.00 0.60–1.37 Large (20+ clinicians) 222 17.1 2.03‡ 1.37–3.02 1.08 0.51–1.41 Other 1 0.1 0.00 0.00 0.00 0.00 Practice ownership Private practice 767 59.1 Ref Ref Ref Ref Hospital or HMO based 309 23.8 1.30 0.99–1.69 0.95 0.68–1.32 FQHC and similar 136 10.5 2.24‡ 1.55–3.25 1.35 0.86–2.14 Other 86 6.6 3.93‡ 2.40–6.44 2.39‡ 1.35–4.24 Medical school faculty No 996 76.7 Ref Ref Ref Ref Yes, Full time 55 4.2 0.73 0.42–1.28 0.55 0.27–1.13 Yes, Part time 247 19.0 0.98 0.74–1.30 1.02 0.74–1.42 Residency faculty No 1,122 86.4 Ref Ref Ref Ref Yes, full time 70 5.4 0.91 0.56–1.48 0.671 0.35–1.30 Yes, part time 106 8.2 1.12 0.752–1.67 0.918 0.57–1.47 Vulnerable patients <10% 395 30.4 Ref Ref Ref Ref 10%–19% 343 26.4 0.90 0.67–1.21 0.96 0.70–1.31 ≥20% 560 43.1 1.39‡ 1.07–1.80 1.10 0.82–1.48 Pharmacist No 1,043 80.4 Ref Ref Ref Ref Yes 255 19.7 3.32‡ 2.48–4.45 1.73‡ 1.18–2.53 Social work No 1,057 81.4 Ref Ref Ref Ref Yes 241 18.6 3.92‡ 2.89–5.33 2.16‡ 1.44–3.26 Behavior specialist No 998 76.9 Ref Ref Ref Ref Yes 300 23.1 2.64‡ 2.02–3.45 1.28 0.88–1.87 Psychiatrist No 1,156 89.1 Ref Ref Ref Ref Yes 142 10.9 3.25‡ 2.22–4.74 1.06 0.64–1.75 ↵* See Appendix Table 3 for full results of regression models.
↵† Variables controlled for include: years in practice, sex, race, ethnicity, employment type.
↵‡ P < .05.
PCMH, patient-centered medical home; HMO, health maintenance organization; FQHC, federally qualified health center; OR, odds ratio; CI, confidence interval; Ref, reference.
- Appendix Table 1.
Respondent-Reported Physician and Practice Site Characteristics by Burnout and Perceived Clinic Social Determinants of Health Capacity Among 1298 Family Physicians Applying for Continuous Certification with the American Board of Family Medicine in 2016
Variable Total (N = 1298) N (%) Burnout Clinic SDH Capacity Burned Out (N = 481) N (%) Not burned Out (N = 1444) N (%) P Value High SDH Capacity (N = 589) N (%) Not High SDH Capacity (N = 709) N (%) P Value Degree MD 1181 (91.0) 312 (88.9) 869 (91.2) 533 (90.5) 648 (91.4) DO 117 (9.01) 39 (11.1) 78 (8.2) .11 56 (9.5) 61 (8.60) .57 Employment Contractor 45 (3.47) 11 (3.1) 34 (3.6) 23 (3.9) 22 (3.1) Employee 847 (65.2) 237 (67.5) 610 (64.4) 403 (68.4) 444 (62.6) Owner 406 (31.3) 103 (29.3) 303 (32.0) .58 163 (27.7) 243 (32.3) .034* Medical school faculty Full time 55 (4.2) 12 (3.4) 43 (4.5) 21 (3.6) 34 (4.8) Part time 247 (19.0) 59 (16.8) 188(19.9) .27 112 (19.0) 135 (19.0) .55 Residency faculty Full time 70 (5.4) 15 (4.3) 55 (5.8) 30 (5.1) 40 (5.6) Part time 106 (8.2) 22 (6.3) 84 (8.9) .15 51 (8.7) 55 (7.8) .78 Primary practice site 1068 (82.3) 284 (80.9) 784 (82.8) 480 (81.5) 588 (82.9) Freestanding ambulatory hospital-based 230 (17.7) 67 (19.1) 163 (17.2) .43 109 (18.5) 121 (17.1) .50 Practice Size (no. of clinicians) Solo 184 (14.2) 38 (10.8) 146 (15.4) 73 (12.4) 111 (15.7) Small (2–5) 439 (33.8) 121 (34.5) 318 (33.6) 171 (29.0) 268 (37.8) Medium (6–20) 452 (34.8) 120 (34.2) 332 (35.1) 217 (36.8) 235 (33.2) Large (20+) 222 (17.1) 72 (20.5) 150 (15.8) 127 (21.6) 95 (13.4) Other 1 (0.1) 0 (0.0) 1 (0.11) .11 1 (0.17) 0 (0.0) <.0001* ↵* P < .05.
SDH, social determinants of health; MD, medical doctor; DO, doctor of osteopathic medicine.
- Appendix Table 2.
Self-Reported Burnout among 1298 Family Physicians Applying for Continuous Certification with the American Board of Family Medicine in 2016: Univariate, Bivariate, and Multivariable Analyses
Variable Total Family Physicians Bivariate: Self-Reported Burnout, n/N = 351/1298 (27.0%) Multivariable Model 1: Self-Reported Burnout Multivariable Model 2: Self-Reported Burnout N = 1298 % OR 95% CI OR 95% CI OR 95% CI Perceived clinic capacity social needs Low (<6) 709 54.6 Ref Ref Ref Ref Ref Ref High (≥6) 589 45.4 0.58* 0.45–0.74 0.71* 0.52–0.98 0.66* 0.47–0.91 % Direct patient care ≤50% 139 10.7 Ref Ref Ref Ref Ref Ref 51%–79% 91 7.0 1.66 0.94–2.97 1.37 0.67–2.77 1.27 0.59–2.73 ≥80% 1068 82.3 1.18 0.78–1.78 0.87 0.53–1.45 0.76 0.41–1.42 Control of workload Poor 74 5.7 Ref Ref Ref Ref Ref Ref Marginal 295 22.7 0.32* 0.18–0.59 0.34* 0.18–0.64 0.33* 0.17–0.62 Satisfactory 485 37.4 0.075* 0.042–0.14 0.092* 0.049–0.17 0.088* 0.046–0.17 Good 349 26.9 0.022* 0.011–0.044 0.035* 0.017–0.072 0.032* 0.015–0.068 Optimal 95 7.3 0.012* 0.0040–0.038 0.019* 0.0060–0.061 0.016* 0.0050–0.054 Team works efficiently Poor/Marginal 104 8.0 Ref Ref Ref Ref Ref Ref Satisfactory 306 23.6 0.40* 0.255–0.624 0.86 0.51–1.44 0.74 0.43–1.27 Good 712 54.9 0.18* 0.118–0.281 0.51* 0.31–0.84 0.45* 0.26–0.75 Optimal 176 13.6 0.11* 0.060–0.191 0.36* 0.18–0.72 0.32* 0.16–0.65 EHR time at home Excessive 284 21.9 Ref Ref Ref Ref Ref Ref Moderate 385 29.7 0.37* 0.27–0.51 0.50* 0.34–0.74 0.51* 0.35–0.75 Satisfactory 225 17.3 0.17* 0.11–0.27 0.34* 0.21–0.57 0.34* 0.20–0.57 Modest 170 13.1 0.24* 0.15–0.37 0.52* 0.31–0.89 0.51* 0.30–0.88 Minimal/None 234 18.0 0.22* 0.15–0.33 0.45* 0.28–0.73 0.45* 0.28–0.75 HR proficiency Poor/Marginal 79 6.1 Ref Ref Ref Ref Ref Ref Satisfactory 336 25.9 0.54* 0.32–0.90 0.67 0.36–1.23 0.650 0.35–1.22 Good 653 50.3 0.57* 0.35–0.93 0.84 0.47–1.50 0.790 0.44–1.44 Optimal 230 17.7 0.51* 0.30–0.88 1.07 0.55–2.07 1.00 0.51–1.98 Stage of PCMH Not applying 435 33.5 Ref Ref Ref Ref Ref Ref Applying 299 23.0 1.04 0.75–1.45 0.96 0.64–1.43 0.98 0.65–1.48 Recognized 564 43.5 1.11 0.84–1.47 0.82 0.58–1.17 0.90 0.62–1.32 Years in practice (1+) Continuous (1–53) 1298 100 0.99 0.98–1.00 0.98 0.96–1.00 0.98 0.96–1.00 Sex Male 573 44.1 Ref Ref Ref Ref Ref Ref Female 725 55.9 0.73* 0.57–0.932 1.13 0.83–1.54 1.05 0.76–1.45 Race White 931 71.7 Ref Ref Ref Ref Ref Ref Non-white 367 28.3 0.77 0.58–1.02 0.80 0.56–1.13 0.76 0.53–1.09 Ethnicity Hispanic 78 6.0 Ref Ref Ref Ref Ref Ref Non-Hispanic 1220 94.0 1.92* 1.04–3.52 1.80 0.90–3.60 1.86 0.91–3.79 Vulnerable patients <10% 395 30.4 Ref Ref Ref Ref Ref Ref 10%–19% 343 26.4 1.36 0.98–1.88 1.44 0.97–2.13 1.53* 1.02–2.28 ≥20% 560 43.1 1.27 0.94–1.70 1.24 0.86–1.79 1.31 0.89–1.93 Practice size Solo 184 14.2 Ref Ref — — Ref Ref Small (2–5 clinicians) 439 33.8 1.46 0.97–2.10 1.19 0.69–2.05 Medium (6–20 clinicians) 452 34.8 1.39 0.92–2.10 1.03 0.58–1.82 Large (20 + clinicians) 222 17.1 1.84* 1.17–2.90 1.74 0.91–3.23 Other 1 0.1 1.00 . 0.00 Practice ownership Private practice 767 59.1 Ref Ref — — Ref Ref Hospital or HMO based 309 23.8 1.05 0.78–1.42 0.83 0.54–1.28 FQHC and similar 136 10.5 1.17 0.79–1.75 1.07 0.60–1.92 Other 86 6.6 1.22 0.75–1.99 1.04 0.53–2.05 Medical school faculty No 996 76.7 Ref Ref — — Ref Ref Yes, full time 55 4.2 0.71 0.37–1.37 1.11 0.44–2.80 Yes, part time 247 19.0 0.80 0.58–1.11 0.81 0.53–1.24 Residency faculty No 1,122 86.4 Ref Ref — — Ref Ref Yes, full time 70 5.4 0.70 0.39–1.26 0.59 0.23–1.54 Yes, part time 106 8.2 0.67 0.41–1.10 0.67 0.35–1.25 Pharmacist No 1,043 80.4 Ref Ref — — Ref Ref Yes 255 19.7 1.16 0.86–1.57 1.23 0.76–1.99 Social work No 1,057 81.4 Ref Ref — — Ref Ref Yes 241 18.6 1.05 0.77–1.43 0.87 0.52–1.46 Behavior specialist No 998 76.9 Ref Ref — — Ref Ref Yes 300 23.1 1.26 0.95–1.68 1.36 0.83–2.21 Psychiatrist No 1,156 89.1 Ref Ref — — Ref Ref Yes 142 10.9 1.24 0.85–1.81 0.97 0.53–1.74 Employment Contractor 45 3.5 Ref Ref — — Ref Ref Employee 847 65.2 0.88 0.67–1.15 1.69* 1.12–2.54 Owner 406 31.1 0.83 0.42–1.67 0.87 0.37–2.03 ↵* P < .05.
OR, odds ratio, CI, confidence interval; PCMH, patient-centered medical home; HMO, health maintenance organization; FQHC, federally qualified health center; EHR, electronic health record; Ref, reference.
- Appendix Table 3.
Univariate, Bivariate, and Multivariable Logistic Analyses Perceived Clinic Capacity to Address Patient's Social Needs among 1298 Family Physicians Applying for Continuous Certification with the American Board of Family Medicine in 2016
Variable Total Family Physicians Bivariate: High Perceived Clinic Capacity, n/N = 589/1298 (45.4%) Multivariable: High Perceived Clinic Capacity, n/N = 589/1298 (45.4%) N = 1298 % OR 95% CI OR 95% CI Practice-level characteristics Stage of PCMH Not applying 435 33.5 Ref Ref Ref Ref Applying 299 23.0 0.90 0.66–1.22 1.00 0.72–1.37 Recognized 564 43.5 1.86* 1.44–2.39 1.65* 1.34–2.21 Practice size Solo 184 14.2 Ref Ref Ref Ref Small (2–5 clinicians) 439 33.8 0.97 0.68–1.34 0.89 0.62–1.36 Medium (6–20 clinicians) 452 34.8 1.40 0.99–1.99 1.00 0.60–1.37 Large (20 + clinicians) 222 17.1 2.03* 1.37–3.02 1.08 0.51–1.41 Other 1 0.1 0.00 0.00 0.00 0.00 Practice ownership Private practice 767 59.1 Ref Ref Ref Ref Hospital or HMO based 309 23.8 1.30 0.99–1.69 0.95 0.68–1.32 FQHC and similar 136 10.5 2.24* 1.55–3.25 1.35 0.86–2.14 Other 86 6.6 3.93* 2.40–6.44 2.39* 1.35–4.24 Medical school faculty No 996 76.7 Ref Ref Ref Ref Yes, full time 55 4.2 0.73 0.42–1.28 0.55 0.27–1.13 Yes, part time 247 19.0 0.98 0.74–1.30 1.02 0.74–1.42 Residency faculty No 1,122 86.4 Ref Ref Ref Ref Yes, full time 70 5.4 0.91 0.56–1.48 0.67 0.35–1.30 Yes, part time 106 8.2 1.12 0.75–1.67 0.92 0.57–1.47 Vulnerable patients <10% 395 30.4 Ref Ref Ref Ref 10%–19% 343 26.4 0.90 0.67–1.21 0.96 0.70–1.31 ≥20% 560 43.1 1.39* 1.07–1.80 1.10 0.82–1.48 Pharmacist No 1,043 80.4 Ref Ref Ref Ref Yes 255 19.7 3.32* 2.48–4.45 1.73* 1.18–2.53 Social work No 1,057 81.4 Ref Ref Ref Ref Yes 241 18.6 3.92* 2.89–5.33 2.16* 1.44–3.26 Behavior specialist No 998 76.9 Ref Ref Ref Ref Yes 300 23.1 2.64* 2.02–3.45 1.28 0.88–1.87 Psychiatrist No 1,156 89.1 Ref Ref Ref Ref Yes 142 10.9 3.25* 2.22–4.74 1.06 0.64–1.75 Individual-level characteristics Years in practice (1+) Continuous (1–53) — — 0.97* 0.96–0.986 0.98* 0.97–1.00 Sex Male 573 44.1 Ref Ref Ref Ref Female 725 55.9 0.95 0.76–1.19 1.23 0.96–1.58 Race White 931 71.7 Ref Ref Ref Ref Non-white 367 28.3 1.75* 1.37–2.23 1.77* 1.34–2.35 Ethnicity Hispanic 78 6.0 Ref Ref Ref Ref Non-Hispanic 1220 94.0 0.78 0.49–1.23 0.66 0.41–1.08 Employment type Employee 847 67.6 Ref Ref Ref Ref Owner 406 31.3 0.74* 0.58–0.94 1.19 0.86–1.63 Contractor 45 3.5 1.15 0.63–2.10 0.94 0.48–1.86 ↵* P < .05.
OR, odds ratio, CI, confidence interval; PCMH, patient-centered medical home; HMO, health maintenance organization; FQHC, federally qualified health center; Ref, reference.
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