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The Influence of Care Management Tools on Physician Practice Change Across Organizational Settings

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Background: A study was conducted to assess whether physician reports of practice change were associated with the type of health care organization delivering the tools and the type or number of tools received.

Methods: A mail survey was sent in 2001 to primary care physicians practicing in the 13 largest urban counties in California.

Results: Physicians were more likely to report a practice change if they received care management tools from a medical group (28%) or a group/staff model health maintenance organization (HMO; 24%) than if they received tools from a health plan (9%; p = .01 and p =.005, respectively). HMO physicians were significantly more likely to receive each type of tool than other physicians. After adjusting for the type or number of tools, the receipt of care management tools from medical groups, but not HMOs, remained a significant predictor of practice change. Physicians reported practice change in association with the number of tools received from a medical group (adjusted odds ratio [AOR] 1.49; 95% confidence interval [CI] 1.08–2.06) and the tools received from an independent practice association, health plan, or hospital outside a medical group (AOR 1.21; 95% CI 1.03–1.42).

Discussion: Medical groups have the strongest influence on practice change, whereas group/staff model HMOs have the highest level of implementation.

Document Type: Research Article

Publication date: 2007-11-01

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  • Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

    David W. Baker, MD, MPH, FACP, executive vice president for the Division of Healthcare Quality Evaluation at The Joint Commission, is the inaugural editor-in-chief of The Joint Commission Journal on Quality and Patient Safety.

    Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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