Four Needles in a Haystack A Systematic Review Assessing Quality of Health Care in Specialty Practice by Practice Type

Specialists, who represent 60% of physicians in the United States, are consolidating into large group practices, but the degree to which group practice type facilitates the delivery of high quality of care in specialty settings is unknown. We conducted a systematic literature review to identify the...

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Podrobná bibliografie
Vydáno v:	Inquiry (Chicago) Ročník 55; s. 1 - 13
Hlavní autoři:	Ellis, Shellie D., Karim, Saleema A., Vukas, Rachel R., Marx, Daniel, Uddin, Jalal
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Los Angeles, CA Sage Publications Inc 01.01.2018 SAGE Publications SAGE PUBLICATIONS, INC SAGE Publishing
Témata:	Criteria Efficiency Group practice Groups Health care delivery Health care expenditures Health care policy Health services Health status Humans Influence Interdisciplinary aspects Literature reviews Medical Subject Headings-MeSH Medicine Organizational factors Patient Satisfaction Patients Peers Physicians Practice Patterns, Physicians' - standards Primary care Quality Quality of care Quality of Health Care - standards Reimbursement Satisfaction Specialists Specialization - standards Specialized services Systematic review Systematic Review or Meta-Analysis United States > US solo practice quality of health care specialty specialty care group practice specialization single specialty multispecialty private practice
ISSN:	0046-9580, 1945-7243
On-line přístup:	Získat plný text
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Popis
Shrnutí:	Specialists, who represent 60% of physicians in the United States, are consolidating into large group practices, but the degree to which group practice type facilitates the delivery of high quality of care in specialty settings is unknown. We conducted a systematic literature review to identify the impact of group practice type on the quality of care among specialty providers. The search resulted in 913 articles, of which only 4 met inclusion criteria. Studies were of moderate methodological quality. From the limited evidence available, we hypothesize that solo specialists deliver care that is inferior to their peers in group practice, whether measured by patient satisfaction ratings or adherence to guideline-based care. However, solo specialists and multidisciplinary group specialists may be more likely to provide some specialized services compared with their single-specialty group peers. Insufficient research compares quality of care among different practice types in specialty care. Substantial opportunity exists to test the degree to which organizational factors, whether size of practice or the mix of providers within the practice, influence quality of care in specialty settings.
Bibliografie:	ObjectType-Article-2 SourceType-Scholarly Journals-1 content type line 14 ObjectType-Feature-3 ObjectType-Evidence Based Healthcare-1 ObjectType-Article-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 ObjectType-Undefined-4
ISSN:	0046-9580 1945-7243
DOI:	10.1177/0046958018787041