Four Needles in a Haystack: A Systematic Review Assessing Quality of Health Care in Specialty Practice by Practice Type

Specialists, who represent 60% of physicians in the United States, are consolidating into large group practices, but the degree to which group practice type facilitates the delivery of high quality of care in specialty settings is unknown. We conducted a systematic literature review to identify the...

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Bibliographic Details
Published in:Inquiry (Chicago) 2018-01, Vol.55, p.1-13
Main Authors: Ellis, Shellie D., Karim, Saleema A., Vukas, Rachel R., Marx, Daniel, Uddin, Jalal
Format: Article
Language:English
Subjects:
Criteria
Efficiency
Health care delivery
Health care expenditures
Health care policy
Humans
Influence
Literature reviews
Medicine
Patient Satisfaction
Patients
Peers
Physicians
Practice Patterns, Physicians' - standards
Primary care
Quality
Quality of care
Quality of Health Care - standards
Reimbursement
Satisfaction
Specialists
Specialization - standards
Systematic review
Systematic Review or Meta-Analysis
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Summary:Specialists, who represent 60% of physicians in the United States, are consolidating into large group practices, but the degree to which group practice type facilitates the delivery of high quality of care in specialty settings is unknown. We conducted a systematic literature review to identify the impact of group practice type on the quality of care among specialty providers. The search resulted in 913 articles, of which only 4 met inclusion criteria. Studies were of moderate methodological quality. From the limited evidence available, we hypothesize that solo specialists deliver care that is inferior to their peers in group practice, whether measured by patient satisfaction ratings or adherence to guideline-based care. However, solo specialists and multidisciplinary group specialists may be more likely to provide some specialized services compared with their single-specialty group peers. Insufficient research compares quality of care among different practice types in specialty care. Substantial opportunity exists to test the degree to which organizational factors, whether size of practice or the mix of providers within the practice, influence quality of care in specialty settings.
ISSN:0046-9580
1945-7243
DOI:10.1177/0046958018787041