title: Environmental factors associated with physician's engagement in communication activities.
abstract: BACKGROUND
  Communication between patients and providers is a crucial component of effective care coordination and is associated with a number of desired patient and provider outcomes. Despite these benefits, physician-patient and physician-physician communication occurs infrequently.
  
  
  OBJECTIVE
  The purpose of this study was to examine the relationship between a medical practice's external environment and physician engagement in communication activities.
  
  
  METHODS
  This was a cross-sectional examination of 4,299 U.S. physicians' self-reported engagement in communication activities. Communication was operationalized as physician's time spent on communication with patients and other providers during a typical work day. The explanatory variables were measures of environmental complexity, dynamism, and munificence. Data sources were the Health Tracking Physician Survey, the Area Resource File database, and the Dartmouth Atlas. Binary logistic regression was used to estimate the association between the environmental factors and physician engagement in communication activities.
  
  
  RESULTS
  Several environmental factors, including per capita income (odds ratio range, 1.17-1.38), urban location (odds ratio range, 1.08-1.45), fluctuations in Health Maintenance Organization penetration (odds ratio range, 3.47-13.22), poverty (odds ratio range, 0.80-0.97) and population rates (odds ratio range, 1.01-1.02), and the presence of a malpractice crisis (odds ratio range, 0.22-0.43), were significantly associated with communication.
  
  
  CONCLUSIONS
  Certain aspects of a physician's external environment are associated with different modes of communication with different recipients (patients and providers). This knowledge can be used by health care managers and policy makers who strive to improve communication between different stakeholders within the health care system (e.g., patient and providers).
authors.affiliation: Olena Mazurenko, PhD, MD, MS, is Assistant Professor, Health Care Administration and Policy, School of Community Health Sciences, University of Nevada, Las Vegas. E-mail: olena.mazurenko@unlv.edu. Larry R. Hearld, PhD, MBA, MSA, is Assistant Professor, School of Health Professions, University of Alabama at Birmingham. E-mail: lhearld@uab.edu.
authors.forename: Olena
authors.initials: O
authors.lastname: Mazurenko
authors.forename: Larry R
authors.initials: LR
authors.lastname: Hearld
mesh_terms: D003142:Communication; D005260:Female; D058016:Health Facility Administration; D006282:Health Personnel / Q000458:organization & administration; D006801:Humans; D008297:Male; D015279:Organizational Culture; D010817:Physician-Patient Relations; D010820:Physicians / Q000458:organization & administration* / Q000706:statistics & numerical data; D014481:United States