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PubMed1978

A faculty and house-staff group practice: report of an operational model.

The internal medicine group practice at Colorado General Hospital was formed in 1974 to improve patient care and educational experience for residents. Six residents, two faculty members, a nurse practitioner, a dietitian, and a group practice coordinator provide 24 hour-a-day, seven day-a-week care for 666 patients. The program features: a balanced degree of faculty and house staff involvement in direct patient care, a high level of accountability provided by the coordinator, and small group size. The first 19 months of operation are reviewed, and the program is contrasted with other group practices reported in the literature.

Adolescent↗
PubMed1976

Continuing education activities of physicians in solo and group practice: report on a pilot study.

Group practice has often been suggested as a form of medical care organization that facilitates professional pursuits, including continuing medical education. A survey was conducted among Iowa physicians in fee-for service multispecialty group practice and in other forms of fee-for-service medical practice, including solo practice and small partnerships to determine their levels of engagement in a number of different types of continuing medical education activities. While several differences between the two groups were found, the survey indicated that overall the levels of engagement for the two groups were similar.

Attitude of Health Personnel↗
PubMed1976

The effect of prepaid group practice on physicians' utilization behavior.

The study is concerned with the practice of physicians in a prepaid group practice setting. Specifically, it is concerned 1) with investigating the extent of variation in physician behavior concerning use of clinical resources, that is, office visits and telephone calls, and technical resources, that is, x-rays and laboratory procedures, and 2) with determining the factors that account for such variation. The universe of this study consists of all internists practicing in 1970 in the prepaid group setting of Kaiser Permanente at Portland, Oregon, a total of 34. The overall framework for the study is based on the belief that medical training and the setting in which physicians work are significant determinants of their use of clinical and technical resources in different disease situations. Specifically, the framework posits that different sets of organizational variables are important in determining use of resources for acute and undiagnosed conditions. The findings reported in the study suggest that while the teaching environment in which a physician is trained is important in shaping his clinical personality, the setting in which he actually works contains its own source of influence over his professional activity. These results also provide supportive evidence for the widely held notion that prepaid group practice, through changing the nature of the incentives to physicians and introducing professional regulation, leads to a more efficient way of providing medical care by reducing the use of costly resources.

Consumer Behavior↗
PubMed1991

[A study of referral pattern of group practice centers in Taiwan].

To investigate the referral patterns of group practice centers in Taiwan, 18 group practice centers were studied. These study sites were sampled in a stratified random method over four districts (eastern, northern, central, and southern) in Taiwan. The study period took place between July 1989 and June 1990. Prospective referral forms were applied in every study site during the 12-month period. A computer-assisted data base for referral contents was established to follow up referral cases. During the study period, 1,647 referrals were generated from 735,534 patient visits, for an overall referral rate of 0.22 percent of all office visits. According to the International Classification of Health Problems in Primary Care, 2nd edition, most of the problems that needed referral were signs, symptoms, ill-defined conditions, digestive system diseases, genitourinary system diseases, circulatory system diseases, neoplasms and musculoskeletal, connective tissue diseases. The top 6 consulting specialties were internal medicine, surgery, obstetrics & gynecology, orthopedics, urology and pediatrics. Periodic evaluation of the dynamic referral contents is a useful method to improve the quality of primary medical care.

Adolescent↗
PubMed1990

The effects of a prepaid group practice on mental health outcomes.

Does a prepaid group practice relative to comparable fee-for-service plans lead to different mental health outcomes for its beneficiaries? To answer this question, we used data from the RAND Health Insurance Experiment. We observed no statistically significant or clinically meaningful differences in mental health outcomes for families randomly assigned to Group Health Cooperative of Puget Sound or to comparable fee-for-service insurance plans in the Seattle area. We found the same null result for overall mental health status as well as for psychological distress (e.g., anxiety and depression) and psychological well-being, and for the full population as well as the initially sick and poor, although our precision was low for the latter comparisons. Thus, the less intensive style of treatment in the prepaid group practice was not associated with noticeably worse mental health outcomes.

Adult↗
PubMed1988

Member characteristics, participation, and interests: Public Health Nutrition Practice Group.

A survey was developed to assess the level of participation and the membership interests of the Public Health Nutrition Practice Group (PHNPG). Forty-six percent (500 members) returned a completed survey. More than 80% of members believe PHNPG to be their main professional practice area "home" within the Council on Practice structure. Members overwhelmingly viewed practice group contributions as a responsibility, with personal career benefits being of secondary importance. Reading the practice group's newsletter and voting in elections were major areas of involvement. However, willingness to contribute time was a positive finding. Areas of interest and issues of greatest concern were identified. Results of the survey can be used to prepare long-range plans for PHNPG. Membership involvement in practice group activities is the key to an increase in re-enrollments and in new memberships.

Data Collection↗
PubMed1976

The role of group practice in the distribution of physicians in nonmetropolitan areas.

The geographic maldistribution of physicians persists as a major obstacle to improving the availability of health services in rural areas. This study looks at group practice as a potential factor in the location of physicians in nonmetropolitan areas. The basic assumptions are 1) the expected conditions of practice are critical to a physician's decision about where to locate, and 2) a group practice form of organization alleviates many of the deterrents to rural practice. The sample for the study is 287 nonmetropolitan trade areas in eight geographic regions of the U.S. Stepwise multiple regression is used to evaluate the relationship of demographic and health system variables, including group practice, to the physician/population ratio. Analyses are done for 1960 and 1970 and then for the change over the ten-year time period. The regression outcomes show that income, population over age 64, and urbanization are most helpful in explaining physician distribution in 1960. In 1970, hospital facilities also contribute. However, the percentage change in the physician/population ratio between 1960 and 1970 is explained by the 1960 physician/population ratio and the per cent of physicians in group practice in 1960. The findings suggest that attractive practice arrangements may be one way to alter the geographic maldistribution of physicians.

Aged↗
PubMed1989

Tax reform legislation and the formation of optometric group practices.

Tax reform legislation through 1987 was analyzed for its impact on whether a partnership form of group practice or a professional corporation form is more advantageous from a federal tax standpoint. The effect of new tax legislation on pension plan contributions and on the deductibility of fringe benefits is delineated and discussed. Several miscellaneous changes in the law affecting group practice modes are discussed. Even though the individual income tax rates are now slightly lower than the corporate income tax rates, there is still life left in the professional corporation form of group practice if the Subchapter S election is made.

Group Practice↗
PubMed1976

Night calls in a group practice.

All the night calls attended in 1974 by seven doctors in a group practice were analysed. Each call was classified by the doctor attending, into categories of urgency.Half of all the night calls were found to be genuine emergencies, and only seven per cent were judged to be totally unnecessary.

Emergencies↗
PubMed1979

Bacteriuria diagnosis and antibiotic susceptibility testing in a group practice by dipslide techniques.

In group practice, screening for bacteriuria and antibacterial susceptibility testing of bacteria in urine specimens were performed by dipslide methods (Uricult and Sensicult, Orion Diagnostica) and the results were evaluated with respect to conventional cultivation of urine specimens and standardized susceptibility testing by the disc diffusion method at a bacteriological laboratory. Bacteriuria diagnosis by screening by the Uricult method seemed to be satisfactorily performed except for some streptococcal strains. In the case of direct susceptibility testing by the Sensicult dipslide method, however, the results obtained by personnel at the surgeries and by trained bacteriologists displayed unacceptable disparities, despite the fact that a continuously running training programme was established.

Anti-Bacterial Agents↗
PubMed1976

The potential of the teaching hospital for the development of prepaid group practices.

This paper deals with the development of a hospital based prepaid group practice at Long Island Jewish-Hillside Medical Center. The paper provides an historical perspective of the factors leading to the decision to develop such a Medical Group practice, the difficulties encountered in obtaining conceptual approval from the Medical Center's Board of Trustees and its medical staff, the negotiations between the Medical Center and Blue Cross-Blue Shield of Greater New York as the insurance company which agreed to market the program and to subsidize it in its developmental stage, factors relating to the contractual negotiations between the Medical Center and Blue Cross, the key elements of the negotiated contract from the standpoint of the prepaid group, and the nature of the subsidies provided to ensure a healthy fiscal beginning. The paper highlights the methods used in achieving the desired goals and the development of the Group, sets forth the resistance which other, similar hospitals might anticipate in undertaking such a venture of their own, and highlights the nature and the degree of commitment necessary to bring such a program into being.

Blue Cross Blue Shield Insurance Plans↗
PubMedDate not supplied

Automated health testing in a medical group practice. Effects on physician behavior and economic influences.

An automated health testing (AHT) laboratory was introduced into a large medical group practice in January 1970. The impact of AHT was studied by means of a matrix of before and after its introduction and the physicians with high and low volumes of referrals to this service. An epidemiologic data-gathering approach was used to obtain information with minimal interference with normal clinic operation during a 3-year period. Data were obtained from the business office, appointment rosters, AHT laboratory results, and clinic records. AHT was accepted and used more frequently by the general and family practice physicians and internists than by the other physicians in the group practice. After AHT was introduced, the general physicians saw fewer patients but held longer visits, performed more procedures, and ordered fewer tests. On the other hand, the internists saw more patients but held shorter visits, performed more periodic reexaminations, and ordered fewer tests. The study findings indicate that in the short term AHT does not appear to reduce the cost of medical care. However, patients benefited from followup of AHT results; often, this followup resulted in significant newly diagnosed diseases or conditions, treatment, and sometimes surgery.

Adult↗