research Performance Evaluation of the Generative Pre-trained Transformer (GPT-4) on the Family Medicine In-Training Examination Read Performance Evaluation of the Generative Pre-trained Transformer (GPT-4) on the Family Medicine In-Training Examination
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Home Research Research Library Physician versus Practice-Level Primary Care Continuity and Association with Outcomes in Medicare Beneficiaries Physician versus Practice-Level Primary Care Continuity and Association with Outcomes in Medicare Beneficiaries 2022 Topic(s) Role of Primary Care, and Achieving Health System Goals Volume Health Services Research Source Health Services Research OBJECTIVE: To compare physician versus practice-level primary care continuity and their association with expenditure and acute care utilization among Medicare beneficiaries and evaluate if continuity of outpatient primary care at either/both physician or/and practice level could be useful quality measures. DATA SOURCE: Medicare Fee-For-Service claims data for community dwelling beneficiaries without End-Stage Renal Disease who were attributed to a national random sample of primary care practices billing Medicare (2011-2017). STUDY DESIGN: Retrospective secondary data analysis at per Medicare beneficiary per year level. We used multivariable linear regression with practice-level fixed effects to estimate continuity of care score at physician vs. practice level and their associations with outcomes. DATA COLLECTION/EXTRACTION METHOD: We calculated clinician and practice level Bice-Boxerman continuity of care index scores, ranging from 0 to 1, using primary care outpatient claims. Medicare expenditures, hospital admissions, emergency department visits, and readmissions were obtained from the Medicare Beneficiary Summary File: Cost and Utilization Segment. Ambulatory care sensitive conditions (ACSC) were defined using diagnosis codes on inpatient claims. PRINCIPAL FINDINGS: We studied 2,359,400 beneficiaries who sought care from 13,926 physicians. Every 0.1 increase in physician continuity score was associated with a $151 reduction in expenditures per beneficiary per year (P<0.01), and every 0.1 increase in practice continuity score was associated with $282 decrease (P<0.01) per beneficiary per year. Both physician- and practice-level continuity were associated with lower Medicare expenditures among small, medium, and large practices. Both physician- and practice-level continuity were associated with lower probabilities of hospitalization, emergency department visit, admissions for ACSC, and readmission. CONCLUSIONS: Primary care continuity of care could serve as a potent value-based care quality metric. Physician-level continuity is a unique value center that cannot be supplanted by practice level continuity. Read More ABFM Research Read all 2023 Foundational Collective Actions for Achieving Agile High-Quality Primary Care in the United States Go to Foundational Collective Actions for Achieving Agile High-Quality Primary Care in the United States 2015 Graduates of Teaching Health Centers Are More Likely to Enter Practice in the Primary Care Safety Net Go to Graduates of Teaching Health Centers Are More Likely to Enter Practice in the Primary Care Safety Net 2023 Racial/Ethnic Minority Identifying Family Physicians Are More Likely to Work in Solo Practices Go to Racial/Ethnic Minority Identifying Family Physicians Are More Likely to Work in Solo Practices 2015 Smaller Practices Are Less Likely to Report PCMH Certification Go to Smaller Practices Are Less Likely to Report PCMH Certification
Topic(s) Role of Primary Care, and Achieving Health System Goals Volume Health Services Research Source Health Services Research
ABFM Research Read all 2023 Foundational Collective Actions for Achieving Agile High-Quality Primary Care in the United States Go to Foundational Collective Actions for Achieving Agile High-Quality Primary Care in the United States 2015 Graduates of Teaching Health Centers Are More Likely to Enter Practice in the Primary Care Safety Net Go to Graduates of Teaching Health Centers Are More Likely to Enter Practice in the Primary Care Safety Net 2023 Racial/Ethnic Minority Identifying Family Physicians Are More Likely to Work in Solo Practices Go to Racial/Ethnic Minority Identifying Family Physicians Are More Likely to Work in Solo Practices 2015 Smaller Practices Are Less Likely to Report PCMH Certification Go to Smaller Practices Are Less Likely to Report PCMH Certification
2023 Foundational Collective Actions for Achieving Agile High-Quality Primary Care in the United States Go to Foundational Collective Actions for Achieving Agile High-Quality Primary Care in the United States
2015 Graduates of Teaching Health Centers Are More Likely to Enter Practice in the Primary Care Safety Net Go to Graduates of Teaching Health Centers Are More Likely to Enter Practice in the Primary Care Safety Net
2023 Racial/Ethnic Minority Identifying Family Physicians Are More Likely to Work in Solo Practices Go to Racial/Ethnic Minority Identifying Family Physicians Are More Likely to Work in Solo Practices
2015 Smaller Practices Are Less Likely to Report PCMH Certification Go to Smaller Practices Are Less Likely to Report PCMH Certification
