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Research ArticleOriginal Research

Patient Characteristics Associated with Making Requests during Primary Care Visits

Joshua J. Fenton, Elizabeth M. Magnan, Anthony Jerant, Richard L. Kravitz and Peter Franks
The Journal of the American Board of Family Medicine March 2019, 32 (2) 201-208; DOI: https://doi.org/10.3122/jabfm.2019.02.180218
Joshua J. Fenton
From the Department of Family and Community Medicine (JJF, EMM, AJ, PF), the Center for Healthcare Policy and Research (JJF, EMM, AJ, RLK, PF), the Division of General Medicine, Department of Internal Medicine (RLK), University of California, Davis Medical Center, Sacramento, CA.
MD, MPH
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Elizabeth M. Magnan
From the Department of Family and Community Medicine (JJF, EMM, AJ, PF), the Center for Healthcare Policy and Research (JJF, EMM, AJ, RLK, PF), the Division of General Medicine, Department of Internal Medicine (RLK), University of California, Davis Medical Center, Sacramento, CA.
MD, PhD
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Anthony Jerant
From the Department of Family and Community Medicine (JJF, EMM, AJ, PF), the Center for Healthcare Policy and Research (JJF, EMM, AJ, RLK, PF), the Division of General Medicine, Department of Internal Medicine (RLK), University of California, Davis Medical Center, Sacramento, CA.
MD
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Richard L. Kravitz
From the Department of Family and Community Medicine (JJF, EMM, AJ, PF), the Center for Healthcare Policy and Research (JJF, EMM, AJ, RLK, PF), the Division of General Medicine, Department of Internal Medicine (RLK), University of California, Davis Medical Center, Sacramento, CA.
MD, MSPH
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Peter Franks
From the Department of Family and Community Medicine (JJF, EMM, AJ, PF), the Center for Healthcare Policy and Research (JJF, EMM, AJ, RLK, PF), the Division of General Medicine, Department of Internal Medicine (RLK), University of California, Davis Medical Center, Sacramento, CA.
MD
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Article Figures & Data

Tables

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    Table 1.

    Patient Characteristics by Whether Requests Were Made During Primary Care Visits (N = 1,319 Visits Among 1141 Patients)

    CharacteristicAny RequestNo RequestP Value
    N, %867 (65.7%)452 (34.3%)
    Age, y, mean (SD)46.4 (15.8)44.2 (16.7).017
    Sex, n%
        Male267 (30.8%)140 (33.6%).38
        Female600 (69.2%)302 (66.8%)
    Race/ethnicity, n%
        White399 (46.0%)226 (50.0%).28
        Hispanic208 (24.0%)91 (20.1%)
        Black104 (12.0%)50 (11.1%)
        Asian53 (6.1%)35 (7.7%)
        Other/multiple races75 (8.7%)31 (6.9%)
        Decline to state28 (3.2%)19 (4.2%)
    Education, n%
        Less than high school35 (4.0%)11 (2.4%).58
        High school/GED135 (15.6%)66 (14.6%)
        Some college315 (36.3%)173 (38.3%)
        College graduate184 (21.2%)101 (22.3%)
        Any graduate studies198 (22.8%)101 (22.3%)
    Self-rated health, n%
        Poor44 (5.1%)13 (2.9%).018
        Fair160 (18.5%)72 (15.9%)
        Good339 (39.1%)158 (35.0%)
        Very good239 (27.6%)149 (33.0%)
        Excellent85 (9.8%)60 (13.3%)
    Mental Health Index, mean (SD)72.5 (19.0)73.9 (18.0).19
    Medical skepticism, mean (SD)3.03 (0.67)3.02 (0.61).78
    Big Five Personality Inventory scores, mean (SD)
    Extraversion3.46 (0.78)3.39 (0.79).16
    Agreeableness4.14 (0.57)4.17 (0.57).34
    Conscientiousness3.91 (0.66)3.94 (0.59).54
    Neuroticism2.74 (0.78)2.71 (0.81).53
    Openness3.80 (0.58)3.78 (0.59).64
    Life satisfaction, mean (SD)25.1 (6.5)25.6 (6.4).17
    Symptom bother/worry, mean (SD)8.40 (2.84)7.57 (2.70)<.001
    Body mass index, mean (SD)30.3 (7.5)29.2 (7.2).012
    Current smoker
        No768 (88.6%)404 (89.4%).66
        Yes99 (11.4%)48 (10.6%)
    Marital status
        Divorced125 (14.4%)46 (10.2%).18
        Married or domestic partnership361 (41.6%)210 (46.5%)
        Member of unmarried couple86 (9.9%)47 (10.4%)
        Never married207 (23.9%)112 (24.8%)
        Separated30 (3.5%)10 (2.2%)
        Widowed58 (6.7%)27 (6.0%)
    Patient satisfaction percentile rank, median (IQR)50.1 (24.1, 78.4)50.1 (25.6, 78.4).79
    Any prior encounter with visit physician
        None472 (54.4%)274 (60.6%).032
        One or more395 (45.6%)178 (39.4%)
    • GED, general equivalency diploma; IQR, interquartile range; SD, standard deviations.

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    Table 2.

    Patient-Level Associations With the Number of Requests per Primary Care Visit (N = 1,319 Visits Attended by 1141 Patients)

    Patient VariableIncidence Rate Ratio95% CIP Value
    Patient age, y1.011.001.01.001
    Female sex (ref = male)0.990.881.12.93
    Race/ethnicity (ref = White)
        Hispanic1.110.961.29.14
        Black0.980.811.18.81
        Asian1.060.841.34.63
        Other/multiple races1.291.061.57.011
        Decline to state0.930.681.26.64
    Education (ref = less than HS)
        High school/GED1.000.741.35.99
        Some college1.000.751.34.98
        College graduate0.990.731.34.94
        Some graduate studies1.040.761.41.81
    Marital status (ref = divorced)
        Married or domestic partner0.950.801.14.60
        Member of unmarried couple1.070.851.36.56
        Never married1.020.831.25.83
        Separated1.070.761.50.69
        Widowed1.030.801.33.79
    Self-reported health status (ref = poor)
        Fair0.920.701.21.55
        Good0.880.671.16.37
        Very good0.770.571.04.091
        Excellent0.760.541.08.13
    Mental Health Index-51.001.001.00.90
    Current smoker (ref = No)1.040.871.24.66
    Body mass index, kg/m21.000.991.01.80
    Symptom bother/worry1.061.031.08<.001
    Medical skepticism1.020.941.11.68
    Big 5 Personality Inventory
        Extraversion1.121.031.08.006
        Agreeableness0.960.861.07.49
        Conscientiousness0.970.871.07.55
        Neuroticism1.000.911.10.99
        Openness0.990.891.10.83
    Life satisfaction1.011.001.02.023
    Patient satisfaction percentile rank1.001.001.00.34
    Any prior encounter with visit physician (ref = no)1.171.041.32.009
    • Estimates for covariates that are significantly associated with request number (P < .05) are shown in bold font.

    • CI, confidential interval; GED, general equivalency diploma; HS, high school.

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The Journal of the American Board of Family     Medicine: 32 (2)
The Journal of the American Board of Family Medicine
Vol. 32, Issue 2
March-April 2019
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Patient Characteristics Associated with Making Requests during Primary Care Visits
Joshua J. Fenton, Elizabeth M. Magnan, Anthony Jerant, Richard L. Kravitz, Peter Franks
The Journal of the American Board of Family Medicine Mar 2019, 32 (2) 201-208; DOI: 10.3122/jabfm.2019.02.180218

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Patient Characteristics Associated with Making Requests during Primary Care Visits
Joshua J. Fenton, Elizabeth M. Magnan, Anthony Jerant, Richard L. Kravitz, Peter Franks
The Journal of the American Board of Family Medicine Mar 2019, 32 (2) 201-208; DOI: 10.3122/jabfm.2019.02.180218
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Keywords

  • Communication
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  • Primary Care Physicians
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