Physician Organization in Relation to Quality and Efficiency of Care: A Synthesis of Recent Literature

Health care providers, researchers, policymakers, and the public have a growing recognition that today’s health care delivery system is not organized to take advantage of the many drivers of quality and efficiency, and that the system suffers from underuse, overuse, and misuse of care. Many experts believe that greater (and different) delivery system organization is fundamental to improved quality and efficiency. This report summarizes and presents a framework for understanding recent research literature linking delivery system organizational attributes with health care efficiency and quality. The focus is on physician groups, as physicians represent the core of any organized delivery system. The report also highlights areas for further research and refinement of the framework and discusses whether and how policymakers can promote specific physician group attributes as a means of improving value. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the author and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This and other Fund publications are available online at www.commonwealthfund.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 1121.

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