Patients’ perception of communication at the interface between primary and secondary care: a cross-sectional survey in 34 countries

Table 2 Factors related to rates of patients’ perception of communication from GPs to medical specialists about their illness when they are referred (multi-response logistic multilevel analysis)

N_countries = 34 N_GPs = 6519 N_patients = 38,432	Odds Ratio^a	(CI)
Patient level
The patient has a personal doctor	1.99	(1.67, 2.36)
GP level
Frequency of referral letters sent to medical specialists by GPs (ref. more than ‘seldom or never’)
Seldom or never	0.75	(0.64, 0.87)
Score of job satisfaction of GPs	1.1	(1.00, 1.22)
Country level
List system in place	0.76	(0.41, 1.41)
Variance country level	1.79
Variance GP level	1.88
Percentage of reduction of variance (Country level)^b	4.2%
Percentage of reduction of variance (GP level)^c	0.7%
Intraclass correlation (ICC) country level	26%
Intraclass correlation (ICC) GP level	27%

CI 95% confidence interval
^aadjusted also for age and gender of GPs, practice location, employment status of GPs, age and gender of patients, income of patients, perceived health status of patients and presence of at least one longstanding disease
^bthis percentage was calculated by using the variance at a country level of the initial model (variance initial model =1.88)
^cthis percentage was calculated by using the variance at a GP level of the initial model (variance initial model =1.90)

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