This research was supported by the Agency for Healthcare Research and Quality (AHRQ), grant R01HS023940.
Journal of The American Board of Family Medicine: JABFM
Cardiovascular system -- Diseases, Primary care (Medicine), Medical care -- United States -- Quality control, Clinics -- Ownership
Purpose: We assessed differences in structural characteristics, quality improvement processes, and cardiovascular preventive care by ownership type among 989 small to medium primary care practices.
Methods: This cross-sectional analysis used electronic health record and survey data collected between September 2015 and April 2017 as part of an evaluation of the EvidenceNOW: Advancing Heart Health in Primary Care Initiative by the Agency for Health Care Research and Quality. We compared physician-owned practices, health system or medical group practices, and Federally Qualified Health Centers (FQHC) by using 15 survey-based practice characteristic measures, 9 survey-based quality improvement process measures, and 4 electronic health record-based cardiovascular disease prevention quality measures, namely, aspirin prescription, blood pressure control, cholesterol management, and smoking cessation support (ABCS).
Results: Physician-owned practices were more likely to be solo (45.0% compared with 8.1%, P < .001 for health system practices and 12.8%, P = .009 for FQHCs) and less likely to have experienced a major change (eg, moved to a new location) in the last year (43.1% vs 65.4%, P = .01 and 72.1%, P = .001, respectively). FQHCs reported the highest use of quality improvement processes, followed by health system practices. ABCS performance was similar across ownership type, with the exception of smoking cessation support (51.0% for physician-owned practices vs 67.3%, P = .004 for health system practices and 69.3%, P = .004 for FQHCs).
Conclusions: Primary care practice ownership was associated with differences in quality improvement process measures, with FQHCs reporting the highest use of such quality-improvement strategies. ABCS were mostly unrelated to ownership, suggesting a complex path between quality improvement strategies and outcomes.
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Lindner, Stephan; Solberg, Leif I.; Miller, William L.; Balasubramanian, Bijal A.; Marino, Miguel; McConnell, K. John; Edwards, Samuel T.; Stange, Kurt C.; Springer, Rachel J.; and Cohen, Deborah J., "Does Ownership Make a Difference in Primary Care Practice?" (2019). OHSU-PSU School of Public Health Faculty Publications and Presentations. 214.