PMID: 22554041May 5, 2012Paper

Primary care physicians' experiences with case finding for practice-based care management.

The American Journal of Managed Care
Tobias FreundJoachim Szecsenyi

Abstract

The identification of patients most likely to benefit from care management programs-case finding-is a crucial determinant of their effectiveness regarding improved health outcomes and reduced costs. Until now, research has mainly focused on claims data-based case finding. This study aimed to explore how primary care physicians (PCPs) select patients for practice based care management and how risk prediction may complement their case finding. Qualitative study. We performed 12 semi-structured interviews with PCPs from 10 small- to middle-sized primary care practices in Germany. The interviews focused on their criteria for selecting patients as potential participants in an on-site care management program and how PCPs evaluate claims data-based risk prediction as a case-finding tool. All interviews were transcribed verbatim. We performed qualitative content analysis using the ATLAS.ti software. Three major categories emerged from the physicians interviewed: 1) the physicians' interpretation of the program's eligibility criteria, 2) physician-related criteria, and 3) patient-related criteria. The physician-related criteria included "sympathy/aversion" and "knowing the patient." Patient-related criteria concerned care sensitivity in...Continue Reading

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