Comparison of Ambulatory Quality Measures Between Shared Practice Panels and Independent Practice Panels

Adria Whiting APRN, CNP , April E. Poolman APRN, CNP, MSN , Artika Misra MD , Joel E. Gordon MD , Kurt B. Angstman MD
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Abstract

Objective

To assess for differences in patient care outcomes in the primary care setting for patients assigned to an independent practice panel (IPP) or a shared practice panel (SPP).

Patients and Methods

We retrospectively reviewed the electronic health records of patients of 2 Mayo Clinic family medicine primary care clinics from January 1, 2019 to December 31, 2019. Patients were assigned to either an IPP (physician or advanced practice provider [APP]) or an SPP (physician and ≥1 APP). We assessed 6 measures of quality care and compared them between IPP and SPP groups: diabetes optimal care, hypertension control, depression remission at 6 months, breast cancer screening, cervical cancer screening, and colon cancer screening.

Results

The study included 114,438 patients assigned to 140 family medicine panels during the study period: 87 IPPs and 53 SPPs. The IPP clinicians showed improved quality metrics compared with the SPP clinicians for the percentage of assigned patients achieving depression remission (16.6% vs 11.1%; P<.01). The SPP clinicians showed improved quality metrics compared with that of the IPP clinicians for the percentage of patients with cervical cancer screening (79.1% vs 74.2%; P<.01). The mean percentage of the panels achieving optimal diabetes control, hypertension control, colon cancer screening, and breast cancer screening were not significantly different between IPP and SPP panels.

Conclusion

This study shows a considerable improvement in depression remission among IPP panels and in cervical cancer screening rates among SPP panels. This information may help to inform primary care team configuration.

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共享诊疗小组与独立诊疗小组的门诊质量措施比较
目的评估被分配到独立实践小组(IPP)或共享实践小组(SPP)的患者在初级保健环境中的患者护理结果差异。患者和方法我们回顾性回顾了2019年1月1日至2019年12月31日梅奥诊所2家家庭医学初级保健诊所患者的电子健康记录。患者被分配到IPP(医师或高级实践提供者[APP])或SPP(医师和≥1名APP)。我们评估了6项优质护理措施,并在IPP和SPP组之间进行了比较:糖尿病最佳护理、高血压控制、6个月时抑郁症缓解、乳腺癌症筛查、癌症宫颈癌筛查和癌症结肠癌筛查。结果研究期间,114438名患者被分配到140个家庭医学小组:87名IPP和53名SPP。与SPP临床医生相比,IPP临床医生在指定患者获得抑郁症缓解的百分比方面的质量指标有所改善(16.6%对11.1%;P<;.01)。与IPP临床医生相比,在宫颈癌症筛查患者的百分比方面,SPP临床医生在质量指标方面有所改善(79.1%对74.2%;P<!.01)在IPP和SPP组之间,实现最佳糖尿病控制、高血压控制、结肠癌癌症筛查和癌症筛查没有显著差异。结论IPP组的抑郁症缓解率和SPP组的宫颈癌症筛查率显著提高。这些信息可能有助于告知初级保健团队的配置。
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来源期刊
Mayo Clinic proceedings. Innovations, quality & outcomes
Mayo Clinic proceedings. Innovations, quality & outcomes Surgery, Critical Care and Intensive Care Medicine, Public Health and Health Policy
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