title: The organization of the health care provider's practice influenced patient participation in research: a multilevel analysis.
abstract: OBJECTIVE
  To analyze the participation of the patients in a survey about prevention, according to their own medical (hypertension and inclusion during house call) and social (occupational class and birthplace) characteristics and characteristics related to the organization of their physicians' practice.
  
  
  METHODS
  Fifty-nine randomly recruited physicians from the Paris metropolitan area enrolled every consecutive patient seen during a 2-week period. Actual patient participation (responding to the telephonic questionnaire) was analyzed with a logistic mixed model separately for male and female patients.
  
  
  RESULTS
  The participation rate among 4,106 eligible patients was 66.7% and varied among physicians (from 48.7% to 80.8% for the 10th and 90th percentiles of the distribution). Participation was better for higher occupational classes, patients included during office visits, men with hypertension, and women born in France. After controlling for all patient characteristics, participation was best if the physician saw at least some patients by appointment [odds ratio (OR), 2.12; 95% confidence interval (CI): 1.12, 4.01 for men and OR, 3.38; 95% CI: 1.72, 6.63 for women). This characteristic explained 14% of the variability between physicians for participation by men and 28% of that by women.
  
  
  CONCLUSIONS
  Cluster studies should take the characteristics of the health care providers into account in their design, particularly their practice organization.
authors: Département de médecine générale, Faculté de médecine, Université Paris Descartes, Sorbonne Paris Cité, 24 rue du Faubourg Saint Jacques, Paris, France. laurent.rigal@inserm.fr
authors: Laurent
authors: L
authors: Rigal
authors: Marie-Joseph
authors: MJ
authors: Saurel-Cubizolles
authors: Hector
authors: H
authors: Falcoff
authors: Jean
authors: J
authors: Bouyer
authors: Virginie
authors: V
authors: Ringa
mesh_terms: D000328:Adult; D000368:Aged; D035843:Biomedical Research / Q000458:organization & administration; D005194:Family Practice / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D009790:Occupations / Q000145:classification; D010297:Paris; D010358:Patient Participation / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012737:Sex Factors; D011795:Surveys and Questionnaires