The Relationships of Physician Practice Characteristics to Quality of Care and Costs

Details

• Personal Author:
  Dowd B ; Knutson D ; Kralewski J ; Savage M ; Tong J
• Description:
  Background: Medical group practices are central to many of the proposals for health care reform, but little is known about the relationship between practice-level characteristics and the quality and cost of care. Methods: Practice characteristics from a 2009 national survey of 211 group practices were linked to Medicare claims data for beneficiaries attributed to the practices. Multivariate regression was used to examine the relationship between practice characteristics and claims-computable measures of screening and monitoring, avoidable utilization, risk-adjusted per-beneficiary per-year (PBPY) costs, and the practice's net revenue. Results: Several characteristics of group practices are predictive of screening and monitoring measures. Those measures, in turn, are predictive of lower values of avoidable utilization measures that contribute to higher PBPY costs. The effects of group practice characteristics on avoidable utilization, cost, and practice net revenue appear to work primarily through improved screening and monitoring. Conclusions: Practice characteristics influence costs indirectly through a set of statistically significant relationships among screening and monitoring measures and avoidable utilization. However, these relationships are not the only pathways connecting practice characteristics to cost and those additional pathways contain substantial "noise" adding uncertainty to the estimated direct effects. Some of the attributes thought to be important characteristics of accountable care organizations and medical homes appear to be associated with lower quality and no improvement in cost. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Economics Health Personnel Occupational Health Safety
• Keywords:
  Author Keywords: Medical Group Practice Structures Costs Economic Impact Health Care Health Care Organizations Medical Care Physicians Policy Quality Of Patient Care Work Organization
• ISSN:
  0017-9124
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Minnesota ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  50
• Issue:
  3
• NIOSHTIC Number:
  nn:20064263
• Citation:
  Health Serv Res 2015 Jun; 50(3):710-729
• Contact Point Address:
  John Kralewski, Ph.D., M.H.A., Medica Research Institute, CW105, 401 Carlson Parkway, Minnetonka, MN
• Email:
  john.kralewski@medica.com
• Federal Fiscal Year:
  2015
• Performing Organization:
  University of Minnesota Twin Cities
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Health Services Research
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a99cb347bb191a6a69bdd3d3a996c1549acebeea8090fbb191773c1d1aaaac4d2d0c60caa1e45acfc98b552cd1fe527f7987b2b47c7c15a6b6b244a0dc7c6b36
• Download URL:
  https://stacks.cdc.gov/view/cdc/222762/cdc_222762_DS1.pdf
• File Type:
  [PDF - 240.74 KB ]