Improving Care Transitions Management: Examining the Role of Accountable Care Organization Participation and Expanded Electronic Health Record Functionality
研究利用美国全国代表性调查数据，发现医生组织参与责任医疗组织和电子健康档案功能越强，越能采用更多护理过渡管理流程，对医疗管理者和政策制定者有参考价值。
OBJECTIVE: Examine the extent to which physician organization participation in an accountable care organization (ACO) and electronic health record (EHR) functionality are associated with greater adoption of care transition management (CTM) processes. DATA SOURCES/STUDY SETTING: A total of 1,398 physician organizations from the third National Study of Physician Organization survey (NSPO3), a nationally representative sample of medical practices in the United States (January 2012-May 2013). STUDY DESIGN: We used data from the third National Study of Physician Organization survey (NSPO3) to assess medical practice characteristics, including CTM processes, ACO participation, EHR functionality, practice type, organization size, ownership, public reporting, and pay-for-performance participation. DATA COLLECTION/EXTRACTION METHODS: Multivariate linear regression models estimated the extent to which ACO participation and EHR functionality were associated with greater CTM capabilities, controlling for practice size, ownership, public reporting, and pay-for-performance participation. PRINCIPAL FINDINGS: Approximately half (52.4 percent) of medical practices had a formal program for managing care transitions in place. In adjusted analyses, ACO participation (p < .001) and EHR functionality (p < .001) were independently associated with greater use of CTM processes among medical practices. CONCLUSIONS: The growth of ACOs and similar provider risk-bearing arrangements across the country may improve the management of care transitions by physician organizations.