title: A comparison of quality and utilization problems in large and small group practices.
abstract: Physicians practicing in large, multispecialty medical groups share an organizational culture that differs from that of physicians in small or independent practices. Since 1980, there has been a sharp increase in the size of multispecialty group practice organizations, in part because of increased efficiencies of large group practices. The greater number of physicians and support personnel in a large group practice also requires a relatively more sophisticated management structure. The efficiencies, conveniences, and management structure of a large group practice provide an optimal environment to practice medicine. However, a search of the literature found no data linking a large group practice environment to practice outcomes. The purpose of the study reported in this article was to determine if physicians in large practices have fewer quality and utilization problems than physicians in small or independent practices.
authors.affiliation: Mercy Clinics, Inc., Des Moines, IA, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Gleason
authors.forename: M J
authors.initials: MJ
authors.lastname: Richards
authors.forename: J E
authors.initials: JE
authors.lastname: Quinnell
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D003659:Decision Making, Organizational; D003953:Diagnosis-Related Groups; D006123:Group Practice / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D007902:Length of Stay; D015279:Organizational Culture; D017063:Outcome Assessment, Health Care; D011331:Private Practice / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care; D014481:United States; D014600:Utilization Review