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A descriptive study of managed-care hassles in 26 practices.
L S Sommers1, T W Hacker, D M Schneider
1Internal Medicine Residency Program, St Mary's Medical Center, San Francisco, CA 94117-1079, USA. lsommers@chw.edu
The Western Journal of Medicine
|March 10, 2001
Summary
Managed care hassles significantly impact primary care, affecting 23% of visits and interfering with care quality. Practice-based research effectively captured these administrative burdens.
Area of Science:
- Primary Care Medicine
- Health Services Research
- Medical Economics
Background:
- Managed care presents administrative challenges in primary care settings.
- Understanding the frequency and impact of these hassles is crucial for physician well-being and patient care.
- Practice-based research offers a feasible method to investigate these issues.
Purpose of the Study:
- To characterize managed care hassles encountered by primary care physicians.
- To assess the feasibility of using practice-based research methods for studying these hassles.
- To quantify the impact of hassles on quality of care and the doctor-patient relationship.
Main Methods:
- Sixteen internists and 10 family physicians participated.
- Data on managed care hassles were collected for 15 consecutive patients per physician using data cards.
- Outcome measures included hassle frequency, duration, and interference with care and patient relationships.
Main Results:
- Physicians found data card use easy to adopt.
- The actual hassle rate was 23%, significantly higher than the estimated 10%.
- Over 40% of hassles interfered with care quality or the doctor-patient relationship.
Conclusions:
- Managed care hassles are frequent and negatively impact primary care delivery.
- Practice-based research is a viable method for studying managed care hassles.
- Further research is warranted to address the significant burden of managed care on physicians.
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