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Organization and Delivery

Integrated Delivery System Research Network (IDSRN)

Strengthening Managed Care

Workshop Summaries

Integrated Delivery Systems In Managed Care: Challenges to State Oversight
Structuring Health Insurance Markets: Protecting Consumers and Promoting Competition
Understanding the Alphabet Soup of Managed Care Integrated Delivery Systems

Research Findings

Research Activities, May 2004:
Deaf and hearing-impaired patients suggest ways doctors can improve communication to improve care quality and safety

Research Activities, April 2004:
Physicians should give patients with kidney failure more information about the option of peritoneal dialysis
Hospitals with low mortality rates for coronary bypass surgery also perform well in valve replacement

Research Activities, March 2004:
Researchers find SCHIP and Medicaid networks compete for physicians in some markets
Study shows the culture of medical group practice changes as practices become larger and more complex

Research Activities, December 2003:
Hospital isolation policies to prevent spread of infection may inadvertently reduce care quality for isolated patients
Use of coagulometers by home health nurses could reduce costs of monitoring the homebound elderly taking warfarin

Research Activities, October 2003:
School-based health centers can help poor children manage their asthma, but they need to follow care guidelines
Group visits to primary care doctors by disadvantaged diabetes patients result in better diabetes care than individual visits
Providing culturally sensitive care may lead to more effective health care delivery for racial/ethnic minorities

Research Activities, September 2003
Delaying the urge to push during second-stage labor offers no benefit for women who receive low-dose epidural analgesia

Research Activities, August 2003:
Regionalization of invasive cardiac procedures may explain seeming underuse of coronary angiography at VA hospitals

Research Activities, July 2003:
Patients who receive stem cell transplants at high-volume transplant centers are less likely to die or fail treatment
Some 911 callers may be safely referred to alternative services to save ambulances for true emergencies
Medicaid shifts to widely used mental health carve-out programs may interrupt therapy among the most needy patients
Children in U.S. managed care plans are far more likely to be referred to specialists than children in the United Kingdom
Job satisfaction for most physicians hinges on good staff relationships, control of time off, and clinical autonomy

Research Activities, March 2003:
Up to one-half of patients seeing complementary and alternative medicine providers are also seeing conventional physicians
Clinical autonomy seems to be the key to career satisfaction among both primary care and specialist physicians

Research Activities, January 2003:
Parents prefer an on-call pediatrician to a nurse advice service to discuss their child's medical problems
Patients who are dissatisfied with their usual source of care may seek costly nonurgent care in the emergency department

Research Activities, December 2002:
Provider-sponsored managed care organizations work best when community leaders and health professionals are involved

Research Activities, November 2002:
Doctors need to be attentive to the weight concerns of disabled adults, who are twice as likely as other adults to be obese
Researchers examine nurse staffing and shortages

Research Activities, October 2002:
Subsidized multiphasic mobile cancer screening units may not be a cost-effective way to reduce cancer morbidity and mortality

Research Activities, May 2002:
Characteristics of medical organizations have a substantial effect on physician satisfaction and well-being

Research Activities, March 2002:
Researchers examine why some patients with chronic kidney disease are referred late to a nephrologist

Research Activities, February 2002:
Coordination mechanisms help hospitals improve delivery of multidisciplinary care for early-stage breast cancer patients
Misunderstandings and miscommunication are hallmarks of a problematic doctor-patient relationship

Research Activities, October 2001:
Primary care doctors had a high rate of job turnover in the late 1980s and early 1990s
Hospital CEOs' views of health care competition influence their choice of physician-organization integration strategies

Research Activities, June 2001:
Researchers examine ways to improve diabetes care in different health care settings

Research Activities, December 2000:
Medical practices can benefit from specific policies for interacting with pharmaceutical representatives

Research Activities, November 2000:
Organizational factors beyond the control of primary care physicians may affect patient satisfaction ratings

Research Activities, September 2000:
One-fourth of generalists and three-fourths of specialists have a subspecialty within their primary specialty
Florida's Medicaid AIDS waiver program improves patients' health and reduces costs, especially for hospital care


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