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CONTEXT Organized care management processes (CMPs) can improve health care quality for patients with chronic diseases. The Institute of Medicine of the National Academy of Sciences has called for public and private purchasers of health care to create incentives for physician organizations (POs) to use CMPs and for the government to assist POs in(More)
CONTEXT Patients with depression and poorly controlled diabetes mellitus, coronary heart disease (CHD), or both have higher medical complication rates and higher health care costs, suggesting that more effective care management of psychiatric and medical disease control might also reduce medical service use and enhance quality of life. OBJECTIVE To(More)
OBJECTIVE To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN Longitudinal analysis. SETTING 35 medical facilities of Kaiser Permanente Northern California, 1997-2007. PARTICIPANTS 2 523 659 adult members of Kaiser(More)
We examined the patient activation measure's (PAM's) association with process and health outcomes among adults with chronic conditions. Patients with high PAM scores were significantly more likely to perform self-management behaviors, use self-management services, and report high medication adherence, compared to patients with the lowest PAM scores. This(More)
BACKGROUND Few studies have investigated the influence of race and/or ethnicity on patients' ratings of quality of care. None have incorporated patients' values and beliefs regarding medical care in assessing these possible differences. OBJECTIVES We explored whether patients' values, ratings, and reports regarding physicians' primary care performance(More)
BACKGROUND Little is known about the economic impact of the acid-related disorders (ARDs), which include dyspepsia, gastritis, gastroesophageal reflux disease (GERD), and peptic ulcer disease (PUD), in managed care patient populations. OBJECTIVES To describe the prevalence of medically attended ARDs, and their direct medical costs from the perspective of(More)
BACKGROUND Intensification of pharmacotherapy in persons with poorly controlled chronic conditions has been proposed as a clinically meaningful process measure of quality. OBJECTIVE To validate measures of treatment intensification by evaluating their associations with subsequent control in hypertension, hyperlipidemia, and diabetes mellitus across 35(More)
About 125 million of the 276 million people living in the United States have some type of chronic illness (table 1). Four chronic conditions affect nearly half of Americans with a chronic disease: asthma, depression, and diabetes each affect about 15 million, while five million have congestive heart failure. In 1999 these four chronic diseases were directly(More)
BACKGROUND Clinical preventive services improve patient health, and reminder systems can increase the use of such services. However, physician organizations often underutilize clinical preventive service reminders. Little is known about the incentives, capabilities, and organizational characteristics associated with the use of reminders by physician(More)
PURPOSE It has been suggested that the best way to improve chronic illness care is through a redesign of primary care emphasizing comprehensive, coordinated care as espoused by the Chronic Care Model (CCM). This study examined the relationship between primary care orientation and the implementation of the CCM in physician organizations. METHODS The(More)