Clinic systems and the quality of care for older adults in residency clinics and in physician practices

Academic Medicine : Journal of the Association of American Medical Colleges
Lorna A LynnEric S Holmboe

Abstract

The U.S. health care system is not prepared to meet the needs of the increasing population of older adults. Few physicians become geriatricians, but most will care for older adults. The authors assessed the quality of care for older adults in residency clinics and physician practices. Using the American Board of Internal Medicine's Care of the Vulnerable Elderly practice improvement module, researchers studied the quality of care provided to older adults in 52 internal and family medicine residency clinic sites and by a motivated group of 144 practicing physicians from 2006 to 2008. They also studied the characteristics of the practice systems in the clinics and offices and the relationship between specific elements of practice systems and the quality of care. Patients seen by residents were younger, had fewer chronic conditions, and were less likely to receive recommended care. Residency clinic systems were less likely to have elements designed to support care for older adults. Even when present, there was little correlation with care provided. Practicing physicians were more likely to provide recommended processes of care, and system elements in their practices were more likely to function well and correlate with delivery of ...Continue Reading

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Citations

May 21, 2011·Journal of General Internal Medicine·Karen L MargolisRussell E Glasgow
Oct 22, 2013·Gerontology & Geriatrics Education·Sara M Bradley, Rosanne M Leipzig
Mar 28, 2012·Academic Medicine : Journal of the Association of American Medical Colleges·Eric S HolmboeLorna A Lynn
Mar 2, 2013·Journal of Graduate Medical Education·Lisa N ConfortiEric S Holmboe
Apr 27, 2011·Journal of the American Geriatrics Society·Brian J HessEric S Holmboe
Dec 18, 2013·Medical Education·Eric Holmboe, Elizabeth Bernabeo
Dec 16, 2010·Medical Education·Eric HolmboeElizabeth Bernabeo
Mar 7, 2019·Gerontology & Geriatrics Education·Channing R FordCynthia J Brown
Oct 3, 2020·Journal of the American Geriatrics Society·Kathryn E CallahanW Jack Rejeski
Jun 24, 2017·Journal of Graduate Medical Education·Kathryn E CallahanJeff D Williamson
Aug 27, 2013·Gerontology & Geriatrics Education·Kathryn E CallahanHelen M Fernandez
Jun 5, 2020·Academic Medicine : Journal of the Association of American Medical Colleges·Jung G KimDiane R Rittenhouse

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