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Survey on Medical Practice Performance Deemed Reliable

Report quashes fear of bias on national patient survey used to calculate part of doctors' pay

THURSDAY, Oct. 1 (HealthDay News) -- A nationwide survey of patients in England, which was used to partially calculate payments to general practitioners, unde-rrepresented some socioeconomic groups, but did not produce biased results leading to inequitable payments to physician practices, according to a study published online Sept. 29 in BMJ.

Martin Roland, of the University of Cambridge in the United Kingdom, and colleagues assessed the 2009 General Practitioner Patient Survey sent to 5.5 million patients, which was used in part to calculate payment to general practitioners. The researchers compared the 2.2 million respondents to the sample and to the general population for representativeness in age, sex, and deprivation. To determine if survey results were biased, the researchers compared practice-level response rates and survey scores and analyzed the variance of scores among practices.

The researchers found that residents of deprived areas, men, and young adults were under-represented among the survey respondents. However, the researchers found no association between practice-level response rates and survey scores. Two questions on the survey to assess practice performance had reliability coefficients of 93.2 and 95.0 percent. Less than 3 and 0.5 percent of practices had fewer than the required number of responses to reach the conventional reliability levels of 90 and 70 percent, respectively.

"There is little evidence to support the concern of some general practitioners that low response rates and selective non-response bias have led to systematic unfairness in payments attached to questionnaire scores," the authors write.

One of the study authors is an employee of the company that developed and delivered the survey and another author was an adviser on the survey.

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