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首页> 美国政府科技报告 >Organizational Characteristics and Chronic Disease Care Final rept. (Sept. 1, 1999-Feb. 29, 2004)
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Organizational Characteristics and Chronic Disease Care Final rept. (Sept. 1, 1999-Feb. 29, 2004)

机译：组织特征和慢性疾病护理最终报告。 （1999年9月1日 - 2004年2月29日）

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The purpose of the report is to identify medical group (MG) and clinic characteristics that predict quality and cost of care for adults with diabetes mellitus (DM) or coronary heart disease (CHD). This prospective cohort study included 19 Minnesota medical groups, 84 primary care clinics, 349 physicians, 2,117 adults with diabetes, and 1,920 adults with CHD. Data were obtained from medical record reviews and surveys of patients, physicians, and clinic and MG leaders. Dependent variables included costs of care and clinical outcomes including LDL-cholesterol levels, systolic (SBP) and diastolic (DBP) blood pressure levels, aspirin (ASA) and tobacco use; and glycated hemoglobin (A1c) levels. There was statistically and clinically significant improvement in DM and CHD care during the study period. Over 90% of variance for all clinical dependent variables was attributed to time or to the patient level. About 4% of variance was attributed to physicians, and 4% of variance was attributable to the clinic or medical groups. After adjustment for patient and physician characteristics, clinic level variables that were predictors of better chronic disease outcomes included quality improvement priorities, use of patient registries, financial incentives, clinic-based health educators, and use of sophisticated information systems. There was considerable variation in resource use across clinics.

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