A national study of about 700 medical groups shows that few perform well on all quality measures for care of chronic illnesses such as asthma, depression, diabetes and heart disease, according to researchers from the University of California at Berkeley. The study, published in the August issue of the Medical Care Research and Review journal, found that only about 11% of the medical groups scored in the top quartile on at least four out of six overall performance measures.
Researchers analyzed the medical groups' use of evidence-based care-management practices and electronic medical records, among other criteria. Stephen Shortell, professor of health policy and management at the university, called it "the first systematic review of medical-group performance on a nationwide scale."
Researchers studied only chronic diseases because they make up about 80% of health expenditures in the U.S., officials said. "Find- ing ways to improve the management of chronic illness will go a long way in reducing those costs and improving the nation's health," Shortell said.
Officials said the study's findings are consistent with recent recommendations from the Institute of Medicine to emphasize organized approaches to quality improvement and focus on external accountability and transparency.