Economic effectiveness of physician organizational models in a California integrated healthcare system.

摘要

This qualitative descriptive case study explored the perceptions of physicians from five different organizational models on contemporary health delivery problems associated with patient access, quality care management, the use of electronic medical records, obstacles to providing care in an ambulatory care setting, medical practice profitability, and the impact of healthcare reform legislation. Although physicians are the single largest determinant of healthcare expenditures, there is scant published research on how physicians perceive their position in the hierarchy of healthcare delivery systems. Findings among the five different organizational models were remarkably consistent across physician groups. Treating the uninsured, low government reimbursements, and the cost of defensive medicine were most often cited as the biggest problems in providing quality medical care. The results of this research may provide an understanding of how physicians function within a group practice environment to contain healthcare costs, improve community health statuses, and enhance personal professional satisfaction.