February 1, 2010
S. M. Shortell, R. Gillies, J, Siddique et al., “Improving Chronic Illness Care: A Longitudinal Cohort Analysis of Large Physician Organizations,” Medical Care, Sept. 2009 47(9):932–39.
Many primary care providers do not take advantage of newly developed tools to treat and manage chronic conditions. A Commonwealth Fund–supported study published in Medical Care
examined the change in use of care management processes among large medical groups. In 2000 and again in 2006, the researchers conducted telephone surveys of medical groups and independent practice associations with 20 or more physicians. Respondents described their organizations’ ownership, size, use of certain chronic disease management processes, financial incentives, involvement in quality improvement, profitability, and use of electronic medical records.
The survey results show that use of chronic disease management processes—mainly the use of patient registries and support for patient self-management—increased 23 percent between 2000 and 2006. The greatest strides were made at practices that receive financial rewards for delivering quality care, those that participate in quality improvement activities, and those that are profitable. The authors conclude that policies that promote financial rewards for quality improvement and encourage improvement activities are likely to improve chronic care.