Analyzing the content of physicians' medical practices.
For many large physician groups, about 75% of all revenues come from capitation contracts. These groups may reduce the variable expenses of patient care by conducting medical outcome studies. Physician groups will obtain the most benefit for their limited research dollars by focusing outcomes research on prevalent medical conditions. The purpose of this study is to provide a comprehensive analysis of the content of physicians' medical practices. We found that 21 diagnostic clusters defined 70% or more of the episodes treated by primary care physicians. For specialists, no more than eight diagnostic clusters were needed to define the majority of their practices. Outcomes research should initially focus on abdominal pain, acute lower respiratory infections, cataracts, cholelithiasis, congestive heart failure, diabetes mellitus, external abdominal hernias, ischemic heart disease, low back pain, maternity care, menstrual disorders, otitis media, peptic diseases, prostate cancer, psychotic episodes, renal calculi, seizure disorders, and thyroid diseases.
Hewitt Associates, Newport Beach, CA.
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D000465:Algorithms; D002140:California; D002204:Capitation Fee; D003625:Data Collection; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D017050:Episode of Care; D006123:Group Practice / Q000458:organization & administration / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data; D006302:Health Services Research / Q000379:methods; D008511:Medicine / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013038:Specialization