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.

Prescription for Health was an initiative funded by the Robert Wood Johnson Foundation in collaboration with the Agency for Healthcare Research and Quality. Under this initiative, primary care practice-based research networks (PBRNs) -- groups of ambulatory practices devoted principally to the primary care of patients -- developed, tested, and evaluated innovative strategies to improve the delivery and effectiveness of health behavior change services in primary care practice. The strategies targeted four health risk behaviors: tobacco use, unhealthy diet, lack of physical activity, and risky alcohol use. Prescription for Health was conducted in two rounds. Round one awarded grants to 17 PBRNs to test the feasibility of implementing the strategies, while round two awarded grants to ten PBRNs to measure the strategies' effectiveness and the expenses associated with them. More than a 100 primary care practices from the ten PBRNs participated in the evaluation.

This data collection comprises the data from one of the data collection efforts carried out by the second round: the responses to the Practice Information Form (PIF), a Web-based instrument which captured key organizational attributes of the participating practices. The PIF data were collected at two time points. Baseline data were collected from each practice before the intervention was implemented and follow-up data were collected approximately one year after the start of the intervention.

Information about the practices collected by the PIF include practice type and ownership; characteristics of each clinician and non-clinician staff person; number of vacancies for clinicians and non clinicians; number of exam rooms and volume of office visits; average number of new patients per month; percentages of patients in various age, race, Hispanic origin, and payer categories; and the predominant type of payment arrangement with health plans. In addition, the PIF asked whether a specific health plan controlled over half of the practice's total business; whether the practice had a pay-for-performance program; whether any payers or organizations publicly reported practice level performance information, such as patient satisfaction, chronic care/disease management, and/or preventive service delivery; and whether practices had a formal process for routinely measuring satisfaction among patients, clinicians, and other staff. The PIF also investigated how practices motivated their clinicians and staff; the level of competition among practices in local markets; the use of computers, electronic medical record systems, and patient registries; major changes that affected each practice's ability to make improvements in patient care; factors that prevented practices from translating the results of research into changes in medical practice; and the use of health risk assessment protocols or questionnaires to identify patients who may benefit from counseling or interventions. Questions about the four Prescription for Health behaviors -- physical activity, healthy eating, smoking cessation, and addressing risky drinking -- asked how practices linked patients to outside resources for each of the four behaviors; how practices used evidence-based guidelines and informed patients about recommendations for the behaviors; and which approaches practices used to support patients ready to engage in a behavior change for each of the behaviors.

These data were collected as part of an assessment of in-person and webinar AFIX consultations on best practices for adolescent HPV immunization. AFIX (which stands for Assessment, Feedback, Incentives, and eXchange) is a program of the Center for Disease Control and Prevention aimed at increasing vaccination of children and adolescents by reducing missed opportunities to vaccinate and improving immunization delivery practices at the provider level.

High-volume primary care clinics serving over 370,000 patients ages 11-17 in three states were randomly assigned to receive no consultation or an in-person or webinar AFIX consultation focused on improving adolescent HPV immunization. Immunization specialists from participating state health departments delivered the consultations. Physicians, nurses and other clinic staff in the in-person and webinar arms who participated in the consultation sessions completed web-based surveys pre-consultation (pre-visit survey), post-consultation (post-visit survey) and at six-month follow up (follow-up survey). Topics covered by the surveys include participation in and satisfaction with the assigned consultation delivery mode; strategies for improving HPV vaccination coverage used by the respondents' clinics; opinions about the level of HPV vaccination coverage in the respondents' clinics; and the respondents' self-efficacy for improving HPV vaccination coverage.