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Primary care physicians’ experience with disease management programs

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Abstract

OBJECTIVE: To examine primary care physicians’ perceptions of how disease management programs affect their practices, their relationships with their patients, and overall patient care.

DESIGN: Cross-sectional mailed survey.

SETTING: The 13 largest urban counties in California.

PARTICIPANTS: General internists, general pediatricians, and family physicians.

MEASUREMENTS AND MAIN RESULTS: Physicians’ self-report of the effects of disease management programs on quality of patient care and their own practices. Respondents included 538 (76%) of 708 physicians: 183 (34%) internists, 199 (38%) family practitioners, and 156 (29%) pediatricians. Disease management programs were available to 285 (53%) physicians; 178 had direct experience with the programs. Three quarters of the 178 physicians believed that disease management programs increased the overall quality of patient care and the quality of care for the targeted disease. Eighty-seven percent continued to provide primary care for their patients in these programs, and 70% reported participating in major patient care decisions. Ninety-one percent reported that the programs had no effect on their income, decreased (38%) or had no effect (48%) on their workload, and increased (48%) their practice satisfaction.

CONCLUSIONS: Practicing primary care physicians have generally favorable perceptions of the effect of voluntary, primary care-inclusive, disease management programs on their patients and on their own practice satisfaction.

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References

  1. Bodenheimer T. Disease management—promises and pitfalls. N Engl J Med. 1999;340:1202–5.

    Article  PubMed  CAS  Google Scholar 

  2. Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE, Carney RM. A multidisciplinary intervention to prevent the read-mission of elderly patients with congestive heart failure. N Engl J Med. 1995;333:1190–5.

    Article  PubMed  CAS  Google Scholar 

  3. Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q. 1996;74:511–44.

    Article  PubMed  CAS  Google Scholar 

  4. Ellrodt G, Cook DJ, Lee J, Cho M, Hunt D, Weingarten S. Evidence-based disease management. JAMA. 1997;278:1687–92.

    Article  PubMed  CAS  Google Scholar 

  5. Wagner EH, Davis C, Schaefer J, Von Korff M, Austin B. A survey of leading chronic disease management programs: are they consistent with the literature? Manag Care Q. 1999;7:56–66.

    PubMed  CAS  Google Scholar 

  6. Lorig KR, Sobel DS, Stewart AL, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care. 1999;37:5–14.

    Article  PubMed  CAS  Google Scholar 

  7. Greenhalgh T, Herxheimer A, Isaacs AJ, Beaman M, Morris J, Farrow S. Commercial partnerships in chronic disease management: proceeding with caution [see comments]. BMJ. 2000;320:566–8.

    Article  PubMed  CAS  Google Scholar 

  8. Kennerly D. Asthma disease management: friend or foe? Allergy Asthma Proc. 1999;20:293–8.

    Article  PubMed  CAS  Google Scholar 

  9. Mason A, Drummond M, Towse A. Is disease management relevant in Europe: some evidence from the United Kingdom. Health Policy. 1999;48:69–77.

    Article  PubMed  CAS  Google Scholar 

  10. Burns H. Disease management and the drug industry: carve out or carve up? Lancet. 1996;347:1021–3.

    Article  PubMed  CAS  Google Scholar 

  11. Harris JM Jr. Disease management: new wine in new bottles? [comment]. Ann Intern Med. 1996;124:838–42.

    PubMed  Google Scholar 

  12. Bodenheimer T, Lo B, Casalino L. Primary care physicians should be coordinators, not gatekeepers. JAMA. 1999;281:2045–9.

    Article  PubMed  CAS  Google Scholar 

  13. Bindman AB, Grumbach K, Vranizan K, Jaffe D, Osmond D. Selection and exclusion of primary care physicians by managed care organizations. JAMA. 1998;279:675–9.

    Article  PubMed  CAS  Google Scholar 

  14. Grumbach K, Osmond D, Vranizan K, Jaffe D, Bindman AB. Primary care physicians’ experience of financial incentives in managed-care systems. N Engl J Med. 1998;339:1516–21.

    Article  PubMed  CAS  Google Scholar 

  15. St. Peter RF, Reed MC, Kemper P, Blumenthal D. Changes in the scope of care provided by primary care physicians. N Engl J Med. 1999;341:1980–5.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Received from the Primary Care Research Center, San Francisco General Hospital, San Francisco, Calif

    Alicia Fernandez MD, Kevin Grumbach MD, Karen Vranizan MA, Dennis H. Osmond PhD & Andrew B. Bindman MD

  2. Division of General Internal Medicine, San Francisco General Hospital, San Francisco, Calif

    Karen Vranizan MA & Andrew B. Bindman MD

  3. Department of Medicine, University of California San Francisco, San Francisco, Calif

    Dennis H. Osmond PhD & Andrew B. Bindman MD

  4. Department of Family and Community Medicine, University of California San Francisco, San Francisco, Calif

    Kevin Grumbach MD

  5. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif

    Dennis H. Osmond PhD & Andrew B. Bindman MD

  6. Center for California Health Workforce Studies, University of California San Francisco, San Francisco, Calif

    Kevin Grumbach MD, Karen Vranizan MA & Andrew B. Bindman MD

Authors
  1. Alicia Fernandez MD
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  2. Kevin Grumbach MD
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  3. Karen Vranizan MA
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  4. Dennis H. Osmond PhD
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  5. Andrew B. Bindman MD
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Corresponding author

Correspondence to Alicia Fernandez MD.

Additional information

The study was also supported by the Agency for Health Care Policy and Research grant #R03HS09557-01 and by the Bureau of Health Professions, HRSA grant # 5U76MB10001.

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Fernandez, A., Grumbach, K., Vranizan, K. et al. Primary care physicians’ experience with disease management programs. J GEN INTERN MED 16, 163–167 (2001). https://doi.org/10.1111/j.1525-1497.2001.91226.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2001.91226.x

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