Sung-Hee Jeon

A randomised trial and economic evaluation of the effect of response mode on response rate, response bias, and item non-response in a survey of doctors

BackgroundSurveys of doctors are an important data collection method in health services research. Ways to improve response rates, minimise survey response bias and item non-response, within a given budget, have not previously been addressed in the same study. The aim of this paper is to compare the effects and costs of three different modes of survey administration in a national survey of doctors.MethodsA stratified random sample of 4.9% (2,702/54,160) of doctors undertaking clinical practice was drawn from a national directory of all doctors in Australia. Stratification was by four doctor types: general practitioners, specialists, specialists-in-training, and hospital non-specialists, and by six rural/remote categories. A three-arm parallel trial design with equal randomisation across arms was used. Doctors were randomly allocated to: online questionnaire (902); simultaneous mixed mode (a paper questionnaire and login details sent together) (900); or, sequential mixed mode (online followed by a paper questionnaire with the reminder) (900). Analysis was by intention to treat, as within each primary mode, doctors could choose either paper or online. Primary outcome measures were response rate, survey response bias, item non-response, and cost.ResultsThe online mode had a response rate 12.95%, followed by the simultaneous mixed mode with 19.7%, and the sequential mixed mode with 20.7%. After adjusting for observed differences between the groups, the online mode had a 7 percentage point lower response rate compared to the simultaneous mixed mode, and a 7.7 percentage point lower response rate compared to sequential mixed mode. The difference in response rate between the sequential and simultaneous modes was not statistically significant. Both mixed modes showed evidence of response bias, whilst the characteristics of online respondents were similar to the population. However, the online mode had a higher rate of item non-response compared to both mixed modes. The total cost of the online survey was 38% lower than simultaneous mixed mode and 22% lower than sequential mixed mode. The cost of the sequential mixed mode was 14% lower than simultaneous mixed mode. Compared to the online mode, the sequential mixed mode was the most cost-effective, although exhibiting some evidence of response bias.ConclusionsDecisions on which survey mode to use depend on response rates, response bias, item non-response and costs. The sequential mixed mode appears to be the most cost-effective mode of survey administration for surveys of the population of doctors, if one is prepared to accept a degree of response bias. Online surveys are not yet suitable to be used exclusively for surveys of the doctor population.

Getting Doctors into the Bush: General Practitioners' Preferences for Rural Location

A key policy issue in many countries is the maldistribution of doctors across geographic areas, which has important effects on equity of access and health care costs. Many government programs and incentive schemes have been established to encourage doctors to practise in rural areas. However, there is little robust evidence of the effectiveness of such incentive schemes. The aim of this study is to examine the preferences of general practitioners (GPs) for rural location using a discrete choice experiment. This is used to estimate the probabilities of moving to a rural area, and the size of financial incentives GPs would require to move there. GPs were asked to choose between two job options or to stay at their current job as part of the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey of doctors. 3727 GPs completed the experiment. Sixty five per cent of GPs chose to stay where they were in all choices presented to them. Moving to an inland town with less than 5000 population and reasonable levels of other job characteristics would require incentives equivalent to 64% of current average annual personal earnings (

The Impact of Lifecycle Events on Women's Labour Force Transitions: A Panel Analysis

116,000). Moving to a town with a population between 5000 and 20,000 people would require incentives of at least 37% of current annual earnings, around

The dynamics of welfare participation among women who experienced teenage motherhood in Australia

68,000. The size of incentives depends not only on the area but also on the characteristics of the job. The least attractive rural job package would require incentives of at least 130% of annual earnings, around

The "Medicine in Australia: Balancing Employment and Life (MABEL)" longitudinal survey - Protocol and baseline data for a prospective cohort study of Australian doctors' workforce participation

237,000. It is important to begin to tailor incentive packages to the characteristics of jobs and of rural areas.

What Factors Influence The Earnings Of General Practitioners And Medical Specialists? Evidence From The Medicine In Australia: Balancing Employment And Life Survey

This panel study explores the impact of different lifecycle events on womens labour force transitions. We explicitly investigate whether the factors that determine entry into the labour force differ from the factors that determine withdrawal from the labour force. The results demonstrate that labour force transitions - entry and withdrawal - occur more frequently among young women. The event of childbirth is strongly associated with labour force withdrawal, while marital separation and reductions in family earnings are strongly associated with labour force entry. Moreover, labour force transition probabilities are more sensitive to income-reducing events than to income-supplementing events. Copyright

What Factors Influence the Earnings of GPs and Medical Specialists in Australia? Evidence from the MABEL Survey

This study examines whether the factors that determine the welfare participation of women who experienced teenage motherhood differ from the factors that determine the welfare participation of women who had their first child at an older age. We examine these factors across the lifetimes of both groups of women. A dynamic random effects probit model is applied to investigate the extent of state dependence in welfare participation while allowing for observed and unobserved individual heterogeneity. We find evidence of state dependence for all women, but it is stronger for women who experienced teenage childbearing than for women who had a child at an older age. In addition, poor health is an important factor in increasing the probability of the welfare participation of women who experienced teenage childbearing.