Primary care physicians' experience with disease management programs

被引:15
作者
Fernandez, A
Grumbach, K
Vranizan, K
Osmond, DH
Bindman, AB
机构
[1] San Francisco Gen Hosp, Primary Care Res Ctr, San Francisco, CA 94110 USA
[2] San Francisco Gen Hosp, Div Gen Internal Med, San Francisco, CA 94110 USA
[3] Univ Calif San Francisco, Dept Med, San Francisco, CA USA
[4] Univ Calif San Francisco, Dept Family & Community Med, San Francisco, CA USA
[5] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA USA
[6] Univ Calif San Francisco, Ctr Calif Hlth Workforce Studies, San Francisco, CA USA
关键词
disease management programs; primary care physicians; quality of care;
D O I
10.1111/j.1525-1497.2001.91226.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
OBJECTIVE: To examine primary care physicians' perceptions of how disease management programs affect their practices, their relationships with their patients, and overall patient care. DESIGN: Cross-sectional mailed survey. SETTING: The 13 largest urban counties in California. PARTICIPANTS: General internists, general pediatricians, and family physicians. MEASUREMENTS AND MAIN RESULTS: Physicians' self-report of the effects of disease management programs on quality of patient care and their own practices. Respondents included 538 (76%) of 708 physicians: 183 (34%) internists, 199 (38%) family practitioners, and 156 (29%) pediatricians. Disease management programs were available to 285 (53%) physicians; 178 had direct experience with the programs. Three quarters of the 178 physicians believed that disease management programs increased the overall quality of patient care and the quality of care for the targeted disease. Eighty-seven percent continued to provide primary care for their patients in these programs, and 70% reported participating in major patient care decisions. Ninety-one percent reported that the programs had no effect on their income, decreased (38%) or had no effect (48%) on their workload, and increased (48%) their practice satisfaction. CONCLUSIONS: Practicing primary care physicians have generally favorable perceptions of the effect of voluntary, primary care-inclusive, disease management programs on their patients and on their own practice satisfaction.
引用
收藏
页码:163 / 167
页数:5
相关论文
共 15 条
  • [1] Selection and exclusion of primary care physicians by managed care organizations
    Bindman, AB
    Grumbach, K
    Vranizan, K
    Jaffe, D
    Osmond, D
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (09): : 675 - 679
  • [2] Primary care physicians should be coordinators, not gatekeepers
    Bodenheimer, T
    Lo, B
    Casalino, L
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 281 (21): : 2045 - 2049
  • [3] Disease management - Promises and pitfalls
    Bodenheimer, T
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (15) : 1202 - 1205
  • [4] Disease management and the drug industry: Carve out or carve up?
    Burns, H
    [J]. LANCET, 1996, 347 (9007) : 1021 - 1023
  • [5] Evidence-based disease management
    Ellrodt, G
    Cook, DJ
    Lee, J
    Cho, M
    Hunt, D
    Weingarten, S
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1997, 278 (20): : 1687 - 1692
  • [6] Commercial partnerships in chronic disease management: proceeding with caution
    Greenhalgh, T
    Herxheimer, X
    Isaacs, AJ
    Beaman, M
    Morris, J
    Farrow, S
    [J]. BRITISH MEDICAL JOURNAL, 2000, 320 (7234): : 566 - 568
  • [7] Primary care physicians' experience of financial incentives in managed-care systems
    Grumbach, K
    Osmond, D
    Vranizan, K
    Jaffe, D
    Bindman, AB
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (21) : 1516 - 1521
  • [8] Disease management: New wine in new bottles?
    Harris, JM
    [J]. ANNALS OF INTERNAL MEDICINE, 1996, 124 (09) : 838 - 842
  • [9] Asthma disease management: Friend or foe?
    Kennerly, D
    [J]. ALLERGY AND ASTHMA PROCEEDINGS, 1999, 20 (05) : 293 - 298
  • [10] Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization - A randomized trial
    Lorig, KR
    Sobel, DS
    Stewart, AL
    Brown, BW
    Bandura, A
    Ritter, P
    Gonzalez, VM
    Laurent, DD
    Holman, HR
    [J]. MEDICAL CARE, 1999, 37 (01) : 5 - 14