the likelihood (propensity-score) of being in the household dataset as a function of observed individual characteristics, and drop those who look “very different” (in a sense made precise below) from the estimation.

# **Section III: Results**

# _Effort and Satisfaction_

Table 4 presents a series of specifications based on Equations 1 and 2. Columns (1) to (4) present the estimations arising from Equation (1), and Columns (5) and (6) present the fixed-effects estimate from Equation (2), where unobserved provider characteristics are removed by comparing differences across patients for the same doctor. The bivariate correlation between doctor-effort and patient satisfaction is highly significant and not affected by the choice of the functional form. In the linear (OLS) specification, a one-standard deviation increase in effort leads to a 7 percentage point increase in patients reporting that they were very satisfied with the interaction; the point-estimate is virtually the same in the non-linear probit specification, which explicitly accounts for the limited dependent nature of the satisfaction variable (satisfaction is either 0 or 1) using a normally distributed error term.

Column 3 adds in observed patient characteristics as additional controls. The estimated coefficient on effort retains both its size and significance. Interestingly, the wealth, health (measured by 5 questions related to activities of daily living) and education level of the patient are unrelated to satisfaction, while age, gender and self reported health status are significant at usual levels of confidence. Elder and male patients tend to report higher satisfaction and those who report that their health status is excellent are also more satisfied. These correlations agree with a large number of studies that find higher satisfaction levels among the elderly and among those in relatively better health (Crow et all 2002).

Adding in observed doctor characteristics (Column 4, Table 4) again has no effect on the reported effect of effort on satisfaction. The age and experience of the doctor has no independent effect on satisfaction, while patients tend to report lower satisfaction for doctors who are male or in urban areas. The interaction between the patient’s and the doctor’s gender is highly significant and large relative to the impact of effort on satisfaction. Patients in an urban area are 15 percentage points more likely to be “very satisfied”; this increase corresponds to a 2.5 standard-deviation increase in the doctor’s effort. Finally, there is some indication that patients report higher satisfaction when an index of treatment, measuring actions related to doctor-patient communication, is higher.

Columns 5 and 6 are the equivalent to Columns 1, and 4 in a fixed-effect specification (Equation 2). There is a large drop in the size and significance of the effect of effort on satisfaction. Once unobserved doctor characteristics are accounted for, a one standard-deviation increase in effort leads to only a one percentage point increase in the probability of being “very satisfied” with the interaction, an increase that is no longer significant. As before, most patient characteristics are uncorrelated with satisfaction, although older and patients with excellent self reported health status continue to report higher satisfaction levels. Thus, while patient characteristics are associated with satisfaction in the same manner as before, there is no longer _any_ observed relationship between patient satisfaction and doctor effort, once we compare satisfaction reports by different patients for the same doctor. This situation corresponds to the hypothetical example discussed in Table 3a.

# _Satisfaction at home and at the facility_

Table 5 compares satisfaction reported by patients interviewed at home and those interviewed at the facility. Columns 1 and 2 report the bivariate correlation between the data type (home or clinic) and satisfaction in OLS and probit specifications; Column 3 introduces the full set of patient controls; Column 4 repeats Column 3 in a fixed-effect specification. Columns 5 and 6 “trim” the sample by 8