Mode and respondent effects in a dual-mode survey of physicians: 2008-2009

The National Ambulatory Medical Care Survey (NAMCS) is an annual in-person survey of office-based physicians and visits to their practices. Since 2008, a supplemental sample of physicians has received a mail questionnaire with NAMCS questions on electronic medical record (EMR)/electronic health record (EHR) systems. In both survey modes, respondents could be either physicians or office staff. This paper compares how mode (mail or in-person) and survey respondent (physician or office staff members) affected estimates of EHR use in the 2008 and 2009 surveys. In both 2008 and 2009, the proportion of physician respondents was higher in the mail survey than the in-person survey. In 2009 only, reports of overall use were associated with survey mode and respondent type. After controlling for mode and respondent type in addition to quarter of the year, practice size, physician specialty, and urban location, the association between mode and EHR use remained significant though the association between respondent type and EHR use did not. Estimates of whether the physician had basic and fully functional EHR systems did not vary by respondent type or survey mode.