Search results

The National Study of Physician Organizations and the Management of Chronic Illness (NSPO) was designed to improve understanding of evidence-based care management processes (CMPs) as they relate to physician organizations (POs), that is, independent practice associations (IPAs) and medical groups. Since the first NSPO survey of physician organizations in 2000-2001 (NSPO1, archived as ICPSR 4455), considerable investments have been made by a number of different sources, including the Robert Wood Johnson Foundation, the California Healthcare Foundation, and The Commonwealth Fund, to bring about improved care for the chronically ill. This survey, the second NSPO survey of IPAs and medical groups (NSPO2), examined the extent to which the investments in quality improvement were translated into action. NSPO2 assessed the status of CMPs and preventive services use as well as their key drivers in 2006-2007 and the extent to which these factors have changed over time. As in the first NSPO survey, NSPO2 focused on the treatment of four chronic diseases: asthma, congestive heart failure (CHF), depression, and diabetes. Topics covered by the survey include practice type, size, age, ownership, and number of locations; clinical information systems; care management and clinical practice; activities of health insurance plans in chronic illness care; performance incentives; preventative care and health promotion; and organizational culture.

This collection has two data files. The first file contains the NSPO2 survey data, while the second contains a crosswalk between the NSPO1 and NSPO2 case identification numbers which can be used to link the data of the POs that responded to both surveys. Altogether, 369 of the 1,104 POs that responded to NSPO1 also responded to NSPO2.

This study investigated the factors that influenced the career decisions of young physicians and the characteristics of their practices. The collection has five datasets: Public-Use Version of the Young Physicians Survey (Dataset 1), Socioeconomic Monitoring System Study (Dataset 2), ZIP Code Data (Dataset 3), Verbatim Responses to the Open-Ended Questions (Dataset 4), and Restricted-Use Version of the Young Physicians Survey (Dataset 5).

The Public-Use Version of the Young Physicians Survey comprises responses from the Young Physicians Survey (YPS), plus merged data from the American Medical Association (AMA) Masterfile and the Association of American Medical Colleges' Student and Applicant Information Management System (SAIMS) database. The YPS interviewed physicians below 40 years of age who recently completed graduate medical training and were in their early years of practice. These physicians were queried about their graduate medical training, perceptions of the medical profession, current practice arrangements, career decisions, family background, patient care activities, and current income and expenses. To obtain information on current practice arrangements, respondents were questioned about the practices they worked in, including who owned the practices, the number of physicians in each practice, specialties or subspecialties practiced, usual fees for selected services, percentages of revenues from HMOs, PPOs, and IPAs, and percentages of patients who were Medicare patients, had no health insurance coverage, or were poor, Black, Hispanic, severely physically disabled, or chronically mentally ill. Questions on career decisions asked respondents about factors that influenced their career choices, such as reasons for working in multiple practices, reasons for leaving past practices, and reasons for deciding in favor of or against self-employment. Information on family background elicited by the survey includes the respondent's race, marital status, and educational debt, parents' income class and education, number of children living in the respondent's home, and whether the respondent's spouse or parents were physicians. Questions on patient care activities included questions on the number of hours spent providing uncompensated health care to the poor, and the number of hours spent with patients in a variety of settings, such as the office, emergency rooms, hospital outpatient clinics, and operating rooms. Information from the AMA Masterfile and the SAIMS database includes board certification status, AMA membership, school and year of graduation, Medical College Admission Test scores, primary undergraduate institution, most recent grade point averages, place of birth, number of acceptances to United States medical schools, parents' occupations, preferred medical specialty, and preferred practice setting.

Dataset 2 comprises responses from the AMA's Socioeconomic Monitoring System (SMS), a semiannual survey of nonfederal physicians that collected data on topics similar to those in the YPS, such as practice ownership, hours spent seeing patients in various settings, income, expenses, and opinions on practice procedures. The SMS data can be used for comparative analyses of young, prime, and senior physicians.

The ZIP Code Data contain estimates for the composition of the population residing in the ZIP code areas of the YPS respondents' main practices. This includes estimates of the size of each ZIP code area population, as well as its components with respect to gender, age, race, Hispanic ethnicity, and income. Also included are estimates of the number of physicians and their composition with respect to age, sex, practice type, and specialty.

Dataset 4 contains verbatim responses to open-ended questions asked in the YPS.

The Restricted-Use Version of the Young Physicians Survey is the same as the Public-Use Version of the Young Physicians Survey, except for some variables that were restricted from general dissemination for reasons of confidentiality. The restricted-use version includes the restricted variables, but the public-use version does not.