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Table 5 Quantile regression estimates of the impact of EHR on patient face time per visit (All covariates)

From: National estimates of the impact of electronic health records on the workload of primary care physicians

Variables At mean visit 10 minute visit 15 minute visit 20 minute Visit 25 minute Visit 30 minute visit
Key independent variables       
 Basic EHR 0.062*** (0.007) 0.053*** (0.012) 0.054*** (0.009) 0.104*** (0.012) 0.112*** (0.011) 0.117*** (0.011)
 Young physician -0.009 (0.008) 0.009 (0.010) 0.010 (0.009) -0.006 (0.009) -0.032*** (0.010) -0.033*** (0.010)
 Older physician 0.007 (0.008) -0.014 (0.012) -0.001 (0.012) 0.049*** (0.012) 0.026** (0.013) 0.030* (0.018)
 Basic EHR * Young physician 0.005 (0.016) 0.016 (0.025) 0.009 (0.021) -0.027* (0.015) -0.030 (0.023) -0.034 (0.024)
 Basic EHR * Older physician 0.006 (0.020) -0.053** (0.021) -0.073*** (0.026) 0.006 (0.031) 0.020 (0.051) 0.025 (0.048)
Patients’ characteristics       
  Age group: (Ref <18)       
 18-34 0.054*** (0.009) 0.016 (0.013) 0.045*** (0.015) 0.021** (0.008) 0.075*** (0.017) 0.070*** (0.015)
 35-49 0.069*** (0.009) 0.038*** (0.012) 0.069*** (0.014) 0.023*** (0.006) 0.088*** (0.013) 0.079*** (0.014)
 50-64 0.082*** (0.009) 0.050*** (0.012) 0.085*** (0.015) 0.044*** (0.009) 0.097*** (0.011) 0.091*** (0.011)
  ≥ 65 0.072*** (0.011) 0.023* (0.014) 0.066*** (0.017) 0.031*** (0.010) 0.085*** (0.013) 0.080*** (0.017)
 Female 0.006 (0.005) 0.007 (0.006) 0.006 (0.006) 0.005 (0.005) 0.017** (0.007) 0.016* (0.009)
Race/ethnicity (Ref: White, non-Hispanic)       
 Black, non-Hispanic -0.039*** (0.007) -0.012 (0.011) -0.018 (0.015) -0.038*** (0.008) -0.040** (0.016) -0.044** (0.018)
 Other race, non-Hispanic -0.017** (0.008) 0.006 (0.010) 0.002 (0.008) -0.019* (0.011) -0.008 (0.016) -0.012 (0.017)
 Hispanic -0.001 (0.007) 0.026*** (0.008) 0.019*** (0.006) -0.010 (0.009) -0.012 (0.010) -0.025** (0.012)
Patient’s health status       
  Major reason for visit (Ref: New problem)       
 Chronic problem 0.052*** (0.005) 0.050*** (0.009) 0.065*** (0.013) 0.049*** (0.007) 0.070*** (0.008) 0.098*** (0.008)
 Pre-/post-surgery or preventive care 0.159*** (0.006) 0.092*** (0.012) 0.102*** (0.014) 0.201*** (0.009) 0.295*** (0.009) 0.273*** (0.008)
  Related to injury/poisoning/ adverse effect -0.033*** (0.008) -0.021** (0.009) -0.022* (0.012) -0.030*** (0.006) -0.040*** (0.015) -0.043*** (0.015)
  Bad disposition (Refer to ED/admit to hospital) 0.151*** (0.026) 0.063 (0.041) 0.063* (0.036) 0.218*** (0.047) 0.287*** (0.033) 0.262*** (0.028)
  Wound care 0.139*** (0.015) 0.058** (0.025) 0.058** (0.025) 0.111*** (0.029) 0.196*** (0.032) 0.206*** (0.040)
  4+ new medications 0.062*** (0.014) 0.062*** (0.012) 0.052*** (0.013) 0.067*** (0.018) 0.081*** (0.023) 0.064*** (0.023)
  1 chronic conditions 0.027*** (0.006) 0.013 (0.009) 0.022* (0.012) 0.021*** (0.005) 0.036*** (0.008) 0.035*** (0.010)
  2 chronic conditions 0.050*** (0.007) 0.059*** (0.013) 0.057*** (0.012) 0.050*** (0.014) 0.049*** (0.012) 0.061*** (0.014)
  3+ chronic conditions 0.074*** (0.008) 0.072*** (0.013) 0.068*** (0.013) 0.117*** (0.015) 0.095*** (0.015) 0.094*** (0.015)
Visit’s characteristics       
  Visit to own primary care physician 0.017** (0.007) 0.030*** (0.008) 0.034*** (0.006) 0.024*** (0.009) 0.003 (0.014) -0.020 (0.017)
  Referred visit 0.087*** (0.016) -0.005 (0.019) -0.001 (0.016) 0.114*** (0.027) 0.121*** (0.024) 0.091*** (0.021)
  Primary source of payment (Ref: Private insurance)       
 Medicare -0.001 (0.008) 0.023*** (0.008) 0.022** (0.010) -0.005 (0.011) 0.002 (0.014) 0.006 (0.017)
 Medicaid -0.005 (0.008) -0.021* (0.011) -0.007 (0.014) 0.000 (0.007) 0.002 (0.012) 0.015 (0.013)
 Other 0.009 (0.007) 0.015* (0.009) 0.017** (0.008) 0.002 (0.006) 0.017* (0.009) 0.029** (0.013)
New patient 0.113*** (0.011) 0.043*** (0.015) 0.067*** (0.014) 0.160*** (0.023) 0.165*** (0.019) 0.155*** (0.020)
Number of visits in last 12 months (Ref: No visit)       
 1 visit -0.010 (0.012) -0.011 (0.015) -0.006 (0.016) -0.021 (0.015) -0.002 (0.015) -0.003 (0.023)
 2 visits -0.031*** (0.012) -0.027** (0.013) -0.018 (0.013) -0.027* (0.015) -0.024 (0.016) -0.031 (0.022)
 3+ visits -0.031*** (0.010) -0.021 (0.014) -0.014 (0.012) -0.034** (0.014) -0.040*** (0.013) -0.044** (0.019)
Weekend visit -0.053*** (0.017) -0.052** (0.026) -0.082** (0.035) -0.019 (0.015) -0.068*** (0.022) -0.058 (0.035)
Seen also by non-MD clinician -0.003 (0.005) -0.006 (0.005) -0.003 (0.006) -0.011 (0.007) -0.006 (0.008) 0.003 (0.010)
Physician characteristics       
Ownership (Ref: physician or physician group)       
 HMO 0.070*** (0.020) 0.094*** (0.032) 0.057*** (0.018) 0.102*** (0.021) 0.024 (0.022) 0.036 (0.037)
 Community health center -0.075*** (0.021) -0.040*** (0.012) -0.057*** (0.016) -0.039** (0.019) -0.060** (0.024) -0.086*** (0.032)
 Other type of ownership -0.033*** (0.007) -0.043*** (0.012) -0.049*** (0.016) -0.016* (0.009) -0.034*** (0.009) -0.042*** (0.011)
 Solo practice 0.058*** (0.006) 0.022*** (0.006) 0.031*** (0.006) 0.065*** (0.007) 0.077*** (0.008) 0.074*** (0.010)
Type of office setting (Ref: Private practice)       
 Free standing 0.001 (0.012) 0.045** (0.019) 0.059*** (0.010) -0.009 (0.015) -0.051*** (0.013) -0.092*** (0.018)
 Community health center 0.090*** (0.020) 0.080*** (0.016) 0.094*** (0.017) 0.077*** (0.023) 0.067*** (0.024) 0.082** (0.032)
 HMO -0.087*** (0.022) -0.170*** (0.052) -0.098*** (0.034) -0.049** (0.020) -0.084*** (0.020) -0.103*** (0.029)
 Other type of office setting 0.133*** (0.026) 0.160*** (0.031) 0.140*** (0.021) 0.132*** (0.045) 0.159*** (0.059) 0.134*** (0.034)
Physician’s incentive to change patient face time       
  Over 50 % of revenue from capitation -0.057*** (0.012) -0.041*** (0.014) -0.038** (0.018) -0.047*** (0.009) -0.099*** (0.015) -0.101*** (0.022)
  Over 50 % of revenue from managed care contract 0.009 (0.005) 0.028*** (0.010) 0.048*** (0.008) -0.002 (0.006) -0.008 (0.007) -0.016** (0.008)
  Over 50 % of revenue from case rate 0.040** (0.017) 0.005 (0.024) -0.019 (0.026) 0.078*** (0.029) 0.081** (0.041) 0.105*** (0.022)
  Other covariates       
  Metropolitan Statistical Area (MSA) 0.018*** (0.007) 0.034*** (0.009) 0.022* (0.013) 0.007 (0.007) -0.012 (0.011) -0.022** (0.011)
Geographic Region (Ref: Northeast)       
 Midwest 0.001 (0.007) -0.056*** (0.018) -0.092*** (0.021) 0.002 (0.010) 0.019* (0.010) 0.020* (0.011)
 South 0.005 (0.007) -0.042** (0.019) -0.024 (0.016) 0.009 (0.011) 0.036*** (0.011) 0.040*** (0.011)
 West 0.064*** (0.007) 0.165*** (0.022) 0.069*** (0.011) 0.014 (0.010) 0.064*** (0.012) 0.080*** (0.013)
N = 37,962       
  1. Note: Visit-level data. Standard errors are in parentheses. Survey year dummies are not shown. Minutes are logged
  2. ***p value < .01
  3. **p value < .05
  4. *p value < .1