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Louise Warrick

Publications and source records attributed to Louise Warrick.

5 recordsLinked to original sources

Evaluating health plan quality 1: a conceptual model.

OBJECTIVE: To develop a theoretical foundation for measuring health plan quality from a physician's perspective. STUDY DESIGN: Literature review and theory development. METHODS: We defined health plan quality as the degree to which health plan management practices increase the likelihood of high-quality care for individuals and populations and addressed the ways in which health plan quality is similar to, and different from, other commonly used quality measures. Based on an assessment of the literature, we proposed a conceptual model that organizes health plan care management practices into a coherent structure for measuring health plan quality. RESULTS: A conceptual model of health plan operation that organizes managerial practices into a structure for measuring health plan quality from a physician's perspective was developed. CONCLUSION: Health plan quality is distinct from quality of care, and physicians can provide unique, timely, and reliable information about aspects of health plan quality.

Attitude of Health Personnel↗

Evaluating health plan quality 2: survey design principles for measuring health plan quality.

OBJECTIVE: To develop principles for measuring the quality of specific health plans from a physician's perspective. STUDY DESIGN: Literature review, expert review, cognitive interviews. METHODS: We did a literature review on the use of physician surveys about managed care to determine the contributions and weaknesses of those surveys. Then, an expert review of prior survey efforts to measure health plan quality from the physician's perspective was performed. RESULTS: A survey instrument based on a conceptual model of health plan quality was developed. Its purpose was to measure health plan quality from the physician's perspective. Principles for surveying physicians guided the structure of the survey. CONCLUSION: Survey instruments can be designed to take into account a physician's unique perspective on health plan quality and can include measures that control for potential biases such as anti-managed care bias.

Attitude of Health Personnel↗

Evaluating health plan quality 3: survey measurement properties.

OBJECTIVE: To assess the measurement and scaling properties of survey items designed to measure health plan quality from a physician's perspective. STUDY DESIGN: Prospective survey design with multivariate regression analysis. METHODS: Data were from 3798 physicians representing 23 health plans in 5 regions: Florida, New York, Colorado, Pennsylvania, and Washington. Scale reliability was assessed by using the Cronbach alpha. Generalist and specialist scales were compared with structural equation modeling. Multivariate analysis was used to examine internal validity by testing theoretically based hypotheses. RESULTS: Scales constructed from the data were reliable, were stable across both generalist and specialist physicians, and demonstrated construct validity. Hypotheses about the relationship between physician experiences with a health plan and physician recommendations of the plan were confirmed, supporting construct validity. CONCLUSION: The items on the survey instrument can be used with confidence to measure health plan quality from a physician perspective.

Attitude of Health Personnel↗

How are health plans supporting physician practice? The physician perspective.

IPA-model HMOs are now the dominant organizational structures for delivering "managed care" in the United States. Are they taking advantage of opportunities to support physician practices in ways that arguably could improve care? In this paper we report the findings from a survey of generalist and specialist physicians in nineteen health plans. Not surprisingly, we found that generalists are much more likely than specialists are to be the target of health plans' efforts to support care delivery. However, our survey data indicate that these opportunities generally are not being fully exploited; also, efforts that plans do make to provide information to support care often are not seen as useful by physicians.

Attitude of Health Personnel↗