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Table 1 Predictors of disenrollment - unadjusted (Model 1) and adjusted regression (Model 2)

From: Changing practice as a quality indicator for primary care: analysis of data on voluntary disenrollment from the English GP Patient Survey

Ā 

Unadjusted (single fixed

Adjusted model*

Ā 

effect) model (Model 1)

(Model 2)

GP Patient Survey Items

Ā Ā Ā Ā 
Ā 

*Rate Ratio

p-value

*Rate Ratio

p-value

Ā 

(95% CI)

Ā 

(95% CI)

Ā 
Ā 

5th vs. 95th

Ā 

5th vs. 95th

Ā 
Ā 

percentile

Ā 

percentile

Ā 

Helpful receptionists

1.34 (1.25, 1.44)

<0.001

0.82 (0.75, 0.89)

<0.001

Getting appointment within 2 days

1.62 (1.51, 1.73)

<0.001

1.09 (1.02, 1.16)

0.016

Booking appointment in advance

1.07 (0.99, 1.14)

0.076

1.07 (1.00, 1.14)

0.055

Seeing preferred doctor

0.77 (0.72, 0.83)

<0.001

0.90 (0.84, 0.96)

0.001

Satisfaction with opening hours

1.64 (1.53, 1.76)

<0.001

0.65 (0.60, 0.70)

<0.001

Doctor/patient communication

4.63 (4.35, 4.94)

<0.001

1.03 (0.87, 1.21)

0.782

Confidence and trust in doctor

4.85 (4.56, 5.16)

<0.001

1.26 (1.06, 1.49)

0.011

Nurse/patient communication

1.71 (1.60, 1.84)

<0.001

0.90 (0.84, 0.96)

<0.001

Overall satisfaction

3.91 (3.66, 4.18)

<0.001

3.46 (2.86, 4.18)

<0.001

Doctorsā€™ Characteristics

Ā Ā Ā Ā 
Ā 

Rate Ratio (95% CI) 95th vs.5th

p-value

Rate Ratio (95% CI) 95th vs. 5th

p-value

Ā Ā Ā 

percentile

Ā 
Ā 

percentile

Ā Ā Ā 

Mean years since FP qualification

3.58 (3.35, 3.83)

<0.001

1.08 (1.01, 1.15)

0.015

Proportion of male FPs

2.21 (2.07, 2.36)

<0.001

1.00 (0.95, 1.05)

0.807

Proportion of overseas qualified FPs

3.52 (3.35, 3.71)

<0.001

0.96 (0.94, 0.98)

<0.001

Patients per full time equivalent FP

1.88 (1.78, 1.98)

<0.001

0.84 (0.81, 0.88)

<0.001

Practice Characteristics

Ā Ā Ā Ā 
Ā 

Rate Ratio (95% CI)

p-value

Rate Ratio (95% CI)

p-value

Number of FPs:

Ā Ā Ā Ā 

1ā€ 

4.29 (4.05, 4.56)

<0.001

2.75 (2.56, 2.95)

<0.001

2

2.92 (2.76, 3.09)

Ā 

2.10 (1.99, 2.22)

Ā 

3

2.03 (1.91, 2.16)

Ā 

1.68 (1.59, 1.76)

Ā 

4

1.52 (1.43, 1.61)

Ā 

1.42 (1.35, 1.49)

Ā 

5

1.23 (1.16, 1.31)

Ā 

1.19 (1.13, 1.25)

Ā 

6-9ā€”

Ref

Ā 

Ref

Ā 

10 or More

0.79 (0.73, 0.86)

Ā 

0.81 (0.76, 0.87)

Ā 

Number of practices within 1km:

Ā Ā Ā Ā 

0ā€ 

Ref

<0.001

Ref

<0.001

1

1.53 (1.44, 1.62)

Ā 

1.21 (1.16, 1.26)

Ā 

2

1.68 (1.57, 1.79)

Ā 

1.21 (1.16, 1.27)

Ā 

3

1.94 (1.81, 2.09)

Ā 

1.23 (1.17, 1.30)

Ā 

4

2.39 (2.20, 2.59)

Ā 

1.32 (1.24, 1.40)

Ā 

5

2.29 (2.09, 2.50)

Ā 

1.24 (1.16, 1.32)

Ā 

6-9ā€”

2.68 (2.49, 2.88)

Ā 

1.36 (1.28, 1.44)

Ā 

10 or More

2.97 (2.61, 3.38)

Ā 

1.40 (1.27, 1.55)

Ā 
  1. * Also adjusted for practice level patient demographics
  2. ā€  Contains 5th percentile
  3. ā€” Contains 95th percentile
  4. * Rate ratios are the relative increase in disenrollment rate associated with moving from the 95th to 5th percentile for patient experience measures, and moving from the 5th to the 95th percentile for other continuous variables. Rate ratio > 1 implies:
  5. For patient experience - disenrollment more likely at worse performing practices compared to better practices
  6. For doctor characteristics - disenrollment more likely at practices with higher values compared to practices with lower values
  7. For practice characteristics - disenrollment more likely compared to reference category