National Study of Physician Organizations and the Management of Chronic Illness (NSPO), 2000-2001 (ICPSR 4455)

Published: May 30, 2006

Principal Investigator(s):
Stephen M. Shortell, School of Public Health, University of California-Berkeley

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The National Study of Physician Organizations and the Management of Chronic Illness (NSPO) examined relationships among physician organization characteristics and the implementation of care management processes (CMP) aimed at improving outcomes and reducing costs for the treatment of four chronic diseases: asthma, congestive heart failure (CHF), depression, and diabetes. To that end, NSPO conducted this national survey of medical groups and independent practice associations (IPA) with 20 or more physicians. An IPA is defined as an organization through which physicians contract with managed care plans. Examples of CMPs include evidence-based clinical practice guidelines, protocols and pathways, case and care management systems, and disease management, demand management, and health promotion programs. Interviews were conducted with the medical director, president, or chief executive officer of each surveyed physician organization. The survey collected data on (1) practice type, size, age, location, and ownership, (2) governance, management, and use of computerized data systems, (3) revenue and overall financial position, (4) physician compensation models, (5) relationships with health plans and degree of risk assumption, and (6) care management and clinical practice -- particularly in regard to asthma, CHF, depression, and diabetes.

Shortell, Stephen M. National Study of Physician Organizations and the Management of Chronic Illness (NSPO), 2000-2001. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2006-05-30.

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Robert Wood Johnson Foundation (38690, 040087)

California HealthCare Foundation (01-1159)

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2000 -- 2001

2000 -- 2001

The goal of NSPO was to collect data on all members of the universe. Four data sources were used to create the sampling frame: the Dorland Healthcare Information 2000 Directory of Physician Groups, the Virginia Commonwealth University Physician Organization Inventory, The National IPA Coalition membership list, and the Medical Group Management Association database. The four sources were used to construct an inventory of medical groups and IPAs with 20 or more physicians, resulting in a contact database of 3,233 organizations, of which 1,646 were found to be ineligible because they could not be located or were no longer in business, were duplicate listings, or did not meet the eligibility criteria. Kaiser Permanente cases were included only on a regional basis, so individual Permanente units were excluded. Of the 1,587 organizations determined to be eligible for the study, 1,104 (69.6 percent) completed the interview.

All medical groups and IPAs in the United States with 20 or more physicians, with the exception of some single-specialty physician organizations composed of specialists who typically do not treat patients for at least one of the chronic diseases of interest (i.e., asthma, CHF, depression, and diabetes). The excluded specialties were radiology, pathology, ophthalmology, anesthesiology, emergency medicine, and/or imaging. Chiropractors, podiatrists, dentists, and optometrists were outside the scope of the study.

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