TY - JOUR
KW - chronic care
KW - integration
KW - Organization and Delivery of Care
AU - M. J. Kerrissey
AU - J. R. Clark
AU - M. W. Friedberg
AU - W. Jiang
AU - A. K. Fryer
AU - M. Frean
AU - S. M. Shortell
AU - P. P. Ramsay
AU - L. P. Casalino
AU - S. J. Singer
A1 - 
AB - Structural integration is increasing among medical groups, but whether these changes yield care that is more integrated remains unclear. We explored the relationships between structural integration characteristics of 144 medical groups and perceptions of integrated care among their patients. Patients' perceptions were measured by a validated national survey of 3,067 Medicare beneficiaries with multiple chronic conditions across six domains that reflect knowledge and support of, and communication with, the patient. Medical groups' structural characteristics were taken from the National Study of Physician Organizations and included practice size, specialty mix, technological capabilities, and care management processes. Patients' survey responses were most favorable for the domain of test result communication and least favorable for the domain of provider support for medication and home health management. Medical groups' characteristics were not consistently associated with patients' perceptions of integrated care. However, compared to patients of primary care groups, patients of multispecialty groups had strong favorable perceptions of medical group staff knowledge of patients' medical histories. Opportunities exist to improve patient care, but structural integration of medical groups might not be sufficient for delivering care that patients perceive as integrated.
BT - Health affairs (Project Hope)
C5 - Education & Workforce
CP - 5
CY - United States
DO - 10.1377/hlthaff.2016.0909
IS - 5
JF - Health affairs (Project Hope)
N2 - Structural integration is increasing among medical groups, but whether these changes yield care that is more integrated remains unclear. We explored the relationships between structural integration characteristics of 144 medical groups and perceptions of integrated care among their patients. Patients' perceptions were measured by a validated national survey of 3,067 Medicare beneficiaries with multiple chronic conditions across six domains that reflect knowledge and support of, and communication with, the patient. Medical groups' structural characteristics were taken from the National Study of Physician Organizations and included practice size, specialty mix, technological capabilities, and care management processes. Patients' survey responses were most favorable for the domain of test result communication and least favorable for the domain of provider support for medication and home health management. Medical groups' characteristics were not consistently associated with patients' perceptions of integrated care. However, compared to patients of primary care groups, patients of multispecialty groups had strong favorable perceptions of medical group staff knowledge of patients' medical histories. Opportunities exist to improve patient care, but structural integration of medical groups might not be sufficient for delivering care that patients perceive as integrated.
PP - United States
PY - 2017
SN - 1544-5208; 0278-2715
SP - 885
EP - 892
EP - 
T1 - Medical Group Structural Integration May Not Ensure That Care Is Integrated, From The Patient's Perspective
T2 - Health affairs (Project Hope)
TI - Medical Group Structural Integration May Not Ensure That Care Is Integrated, From The Patient's Perspective
U1 - Education & Workforce
U2 - 28461356
U3 - 10.1377/hlthaff.2016.0909
VL - 36
VO - 1544-5208; 0278-2715
Y1 - 2017
ER -