University of California, San Francisco, CA 94143, USA.
Med Care Res Rev. 2010 Jun;67(3):301-20. doi: 10.1177/1077558709353324. Epub 2010 Jan 6.
The use of evidence-based care management processes (CMPs) in physician practice is an important component of delivery-system reform.The authors used data from a 2006-2007 national study of large physician organizations-medical groups and independent practice associations (IPAs) to determine the extent to which organizations use CMPs, and to identify external (market) influences and organizational capabilities associated with CMP use. The study found that physician organizations use about half of recommended CMPs, most commonly disease registries, specially trained patient educators, and performance feedback to physicians. Physician organizations that reported participating in quality improvement programs, having a patient-centered focus, and being owned by a hospital or health maintenance organization used more CMPs. IPAs and very large medical groups used more CMPs than smaller groups. Organizations externally evaluated on quality measures used more CMPs than other organizations. These findings can inform efforts to stimulate the adoption of best practices for chronic illness care.
循证护理管理流程（CMP）在医生实践中的应用是医疗服务体系改革的重要组成部分。作者使用了 2006-2007 年对大型医生组织（医疗集团和独立执业协会）的全国性研究的数据，以确定组织使用 CMP 的程度，并确定与 CMP 使用相关的外部（市场）影响因素和组织能力。研究发现，医生组织使用了约一半推荐的 CMP，最常见的是疾病登记、专门培训的患者教育者和对医生的绩效反馈。报告参与质量改进计划、以患者为中心以及由医院或医疗保健组织所有的医生组织使用了更多的 CMP。IPA 和非常大的医疗集团比小团体使用了更多的 CMP。根据质量措施进行外部评估的组织比其他组织使用了更多的 CMP。这些发现可以为激励慢性病护理最佳实践的采用提供信息。
