Influence of Primary Care Practice and Provider Attributes on Preventive Service Delivery

Dorothy Y. Hung; Thomas G. Rundall; Benjamin F. Crabtree; Alfred F. Tallia; Deborah J. Cohen; Helen A. Halpin

doi:10.1016/j.amepre.2005.12.012

Influence of Primary Care Practice and Provider Attributes on Preventive Service Delivery

Dorothy Y. Hung, Thomas G. Rundall, Benjamin F. Crabtree, Alfred F. Tallia, Deborah J. Cohen, Helen A. Halpin

Research output: Contribution to journal › Article › peer-review

39 Scopus citations

Abstract

Background: While visits to the doctor's office are appropriate times to advise patients on health behaviors, these opportunities are often missed. Lapses in care quality are no longer attributed solely to individuals, but are also increasingly understood to be the result of organizational factors. This research examines the influence that both practice and provider attributes have on the delivery of preventive services for health behaviors. Methods: This study used data collected from the Prescription for Health initiative sponsored by the Robert Wood Johnson Foundation. Quantitative data on 52 primary care practices and 318 healthcare providers were gathered from September 2003 to September 2004, and were analyzed upon completion of data collection. Hierarchical linear modeling was used to examine associations between both practice and provider attributes and preventive service delivery. Results: Practice staff participation in decisions regarding quality improvement, practice change, and clinical operations positively influenced the effect of work relationships and negatively influenced the effect of practice size on service delivery. Nurse practitioners and allied health professionals reported more frequent delivery of services compared to physicians. Last, use of reminder systems and patient registries were positively associated with preventive service delivery. Conclusions: This study offers preliminary support for staff participation in practice decisions as a positive aspect of teamwork and collaboration. Findings also suggest leveraging nonphysician clinical staff and organized clinical systems to improve the delivery of preventive services for health behaviors.

Original language	English (US)
Pages (from-to)	413-422
Number of pages	10
Journal	American journal of preventive medicine
Volume	30
Issue number	5
DOIs	https://doi.org/10.1016/j.amepre.2005.12.012
State	Published - May 2006
Externally published	Yes

ASJC Scopus subject areas

Epidemiology
Public Health, Environmental and Occupational Health

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10.1016/j.amepre.2005.12.012

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@article{fd2644bfc1f44922ac9e4c9870bebfb4,

title = "Influence of Primary Care Practice and Provider Attributes on Preventive Service Delivery",

abstract = "Background: While visits to the doctor's office are appropriate times to advise patients on health behaviors, these opportunities are often missed. Lapses in care quality are no longer attributed solely to individuals, but are also increasingly understood to be the result of organizational factors. This research examines the influence that both practice and provider attributes have on the delivery of preventive services for health behaviors. Methods: This study used data collected from the Prescription for Health initiative sponsored by the Robert Wood Johnson Foundation. Quantitative data on 52 primary care practices and 318 healthcare providers were gathered from September 2003 to September 2004, and were analyzed upon completion of data collection. Hierarchical linear modeling was used to examine associations between both practice and provider attributes and preventive service delivery. Results: Practice staff participation in decisions regarding quality improvement, practice change, and clinical operations positively influenced the effect of work relationships and negatively influenced the effect of practice size on service delivery. Nurse practitioners and allied health professionals reported more frequent delivery of services compared to physicians. Last, use of reminder systems and patient registries were positively associated with preventive service delivery. Conclusions: This study offers preliminary support for staff participation in practice decisions as a positive aspect of teamwork and collaboration. Findings also suggest leveraging nonphysician clinical staff and organized clinical systems to improve the delivery of preventive services for health behaviors.",

author = "Hung, {Dorothy Y.} and Rundall, {Thomas G.} and Crabtree, {Benjamin F.} and Tallia, {Alfred F.} and Cohen, {Deborah J.} and Halpin, {Helen A.}",

note = "Funding Information: This study was supported by the Robert Wood Johnson Foundation (grant 47075). We would like to thank Michelle Gibel for her help with data collection and the practices from the 17 practice-based research networks for participating in this study. We also thank Steve Shortell, PhD, and Laura Stoker, PhD, for reviewing initial drafts of this manuscript, and for lending their insights and expertise to this work. Funding Information: This research used data collected from the Prescription for Health initiative, a national program sponsored by the Robert Wood Johnson Foundation. The initiative funded investigative teams from 17 practice-based research networks to implement innovative programs targeting lifestyle behaviors such as diet, physical activity, and tobacco and alcohol use. Primary care practices located throughout the northeastern, southern, midwestern, and western regions of the United States participated in this initiative. ",

year = "2006",

month = may,

doi = "10.1016/j.amepre.2005.12.012",

language = "English (US)",

volume = "30",

pages = "413--422",

journal = "American journal of preventive medicine",

issn = "0749-3797",

publisher = "Elsevier Inc.",

number = "5",

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T1 - Influence of Primary Care Practice and Provider Attributes on Preventive Service Delivery

AU - Hung, Dorothy Y.

AU - Rundall, Thomas G.

AU - Crabtree, Benjamin F.

AU - Tallia, Alfred F.

AU - Cohen, Deborah J.

AU - Halpin, Helen A.

N1 - Funding Information: This study was supported by the Robert Wood Johnson Foundation (grant 47075). We would like to thank Michelle Gibel for her help with data collection and the practices from the 17 practice-based research networks for participating in this study. We also thank Steve Shortell, PhD, and Laura Stoker, PhD, for reviewing initial drafts of this manuscript, and for lending their insights and expertise to this work. Funding Information: This research used data collected from the Prescription for Health initiative, a national program sponsored by the Robert Wood Johnson Foundation. The initiative funded investigative teams from 17 practice-based research networks to implement innovative programs targeting lifestyle behaviors such as diet, physical activity, and tobacco and alcohol use. Primary care practices located throughout the northeastern, southern, midwestern, and western regions of the United States participated in this initiative.

PY - 2006/5

Y1 - 2006/5

N2 - Background: While visits to the doctor's office are appropriate times to advise patients on health behaviors, these opportunities are often missed. Lapses in care quality are no longer attributed solely to individuals, but are also increasingly understood to be the result of organizational factors. This research examines the influence that both practice and provider attributes have on the delivery of preventive services for health behaviors. Methods: This study used data collected from the Prescription for Health initiative sponsored by the Robert Wood Johnson Foundation. Quantitative data on 52 primary care practices and 318 healthcare providers were gathered from September 2003 to September 2004, and were analyzed upon completion of data collection. Hierarchical linear modeling was used to examine associations between both practice and provider attributes and preventive service delivery. Results: Practice staff participation in decisions regarding quality improvement, practice change, and clinical operations positively influenced the effect of work relationships and negatively influenced the effect of practice size on service delivery. Nurse practitioners and allied health professionals reported more frequent delivery of services compared to physicians. Last, use of reminder systems and patient registries were positively associated with preventive service delivery. Conclusions: This study offers preliminary support for staff participation in practice decisions as a positive aspect of teamwork and collaboration. Findings also suggest leveraging nonphysician clinical staff and organized clinical systems to improve the delivery of preventive services for health behaviors.

AB - Background: While visits to the doctor's office are appropriate times to advise patients on health behaviors, these opportunities are often missed. Lapses in care quality are no longer attributed solely to individuals, but are also increasingly understood to be the result of organizational factors. This research examines the influence that both practice and provider attributes have on the delivery of preventive services for health behaviors. Methods: This study used data collected from the Prescription for Health initiative sponsored by the Robert Wood Johnson Foundation. Quantitative data on 52 primary care practices and 318 healthcare providers were gathered from September 2003 to September 2004, and were analyzed upon completion of data collection. Hierarchical linear modeling was used to examine associations between both practice and provider attributes and preventive service delivery. Results: Practice staff participation in decisions regarding quality improvement, practice change, and clinical operations positively influenced the effect of work relationships and negatively influenced the effect of practice size on service delivery. Nurse practitioners and allied health professionals reported more frequent delivery of services compared to physicians. Last, use of reminder systems and patient registries were positively associated with preventive service delivery. Conclusions: This study offers preliminary support for staff participation in practice decisions as a positive aspect of teamwork and collaboration. Findings also suggest leveraging nonphysician clinical staff and organized clinical systems to improve the delivery of preventive services for health behaviors.

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JO - American journal of preventive medicine

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IS - 5

ER -

Influence of Primary Care Practice and Provider Attributes on Preventive Service Delivery

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