title: Factors associated with GPs' knowledge of their patients' socio-economic circumstances: a multilevel analysis.
abstract: BACKGROUND
  To determine appropriate management for individual patients, GPs are supposed to use their knowledge of the patient's socio-economic circumstances.
  
  
  OBJECTIVE
  To analyse factors associated with GPs' knowledge of these circumstances.
  
  
  METHODS
  Observational survey of GPs who were internship supervisors in the Paris metropolitan area. Each of 52 volunteer GPs completed a self-administered questionnaire about their own characteristics and randomly selected 70 patients from their patient list. Their knowledge was analysed as the agreement between the patients' and GPs' responses to questions about the patients' socio-economic characteristics in questionnaires completed by both groups. The association between agreement and the GPs' characteristics was analysed with a multilevel model adjusted for age, sex and the duration of the GP-patient relationship.
  
  
  RESULTS
  Agreement varied according to the socio-economic characteristics considered (from 51% to 90%) and between GPs. Globally, the GPs overestimated their patients' socio-economic level. GP characteristics associated with better agreement were sex (female), long consultations, the use of paper records or an automatic reminder system and participation in continuing medical education and in meetings to discuss difficult cases.
  
  
  CONCLUSIONS
  Knowledge of some patient characteristics, such as their complementary health insurance coverage or perceived financial situation, should be improved because their overestimation may lead to care that is too expensive and thus result in the patients' abandonment of the treatment. Besides determining ways to help GPs to organize their work more effectively, it is important to study methods to help doctors identify their patients' social-economic circumstances more accurately in daily practice.
authors: Aix Marseille University, Department of general practice, Marseille.
authors: Ludovic
authors: L
authors: Casanova
authors: Inserm, Centre for research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, Villejuif, Paris-Sud University, UMRS 1018, Villejuif, Ined, Paris.
authors: Virginie
authors: V
authors: Ringa
authors: LEDi, University of Burgundy, UMR CNRS 6307, Inserm U1200, Dijon.
authors: Géraldine
authors: G
authors: Bloy
authors: Sorbonne Paris Cité, Paris Descartes University, Department of General Practice, Paris and Société de Formation Thérapeutique du Généraliste, Paris, France.
authors: Hector
authors: H
authors: Falcoff
authors: Inserm, Centre for research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, Villejuif, Paris-Sud University, UMRS 1018, Villejuif, Ined, Paris, Sorbonne Paris Cité, Paris Descartes University, Department of General Practice, Paris and laurent.rigal@parisdescartes.fr.
authors: Laurent
authors: L
authors: Rigal
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D005602:France; D058005:General Practitioners / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Continuing medical education; general practitioners; medical records; physician’s role; social environment; socio-economic factors.