PMID: 4680Apr 1, 1976

The role of new health practitioners in a prepaid group practice: provider differences in process and outcomes of medical care

Medical Care
D M LevineF E Malitz

Abstract

Practice patterns and patient-reported outcomes of care are compared in detail for ten physicians and 12 new health practitioners delivering ambulatory care in two departments of a prepaid group practice, the Columbia Medical Plan (CMP). All providers completed questionnaires for a 50 per cent random sample of patients seen during a two-week period. Patients completed questionnaires prior to receiving care and were interviewed one week and one month after their clinic visits. New health practitioners deliver approximately 75 per cent of well-person care, 56 per cent of problem-oriented care in adult medicine, and 29 per cent of problem care in pediatrics. They have become increasingly involved over time in the treatment of acute conditions and injuries while physicians have retained their predominant role in treating patients with chronic conditions. Thirty-two per cent of visits with new healh providers involved a physician in one or more of the following: decision-making, direct supervision, consultation, or seeing the patient as a second provider of care. Degree of autonomy varied by type of task performed, category of problem treated, and specialty. The following outcomes of care were examined by type of provider: patient-r...Continue Reading

Citations

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Related Concepts

Acute Disease
Health Care Systems
Group Practice
Health Insurance, Voluntary
Health Care Seeking Behavior
Pediatric Discipline
Feldshers
Preventive Health Services
Quality of Health Care
Patient Referral

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