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Research ArticleOriginal Article

Putting Population-Based Care Into Practice: Real Option or Rhetoric?

Stephen Taplin, Mary Sue Galvin, Tom Payne, David Coole and Ed Wagner
The Journal of the American Board of Family Practice March 1998, 11 (2) 116-126; DOI: https://doi.org/10.3122/15572625-11-2-116
Stephen Taplin
From the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle.
MD
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Mary Sue Galvin
From the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle.
FNP
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Tom Payne
From the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle.
MD
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David Coole
From the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle.
MS
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Ed Wagner
From the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle.
MD
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Abstract

Background: Efforts to improve care have focused on population-based approaches, though little practical information exists about implementation.

Methods: This report reviews relevant literature on teamwork in the context of a time-series evaluation of a demonstration project to reorganize care of a single panel of patients in a managed care setting. The proportion of the study panel achieving recommended levels for breast and colon cancer screening, warfarin control, and diabetic eye care was compared with the surrounding practice panels and the managed care population as a whole. Using unconditional logistic regression, we compared changes within populations between March 1993 and March 1995, and the rate of change between populations during the same period.

Results: A model of team care was successfully implemented. Colon (occult blood in the stool) and breast (mammography) screening increased more rapidly in the study population than in the surrounding practices or plan as a whole (P < 0.05 for all comparisons). There was no significant improvement in warfarin control or diabetic eye examinations, though absolute increases occurred.

Conclusion: This work shows that a team approach to population-based care is a real option. Such an approach, however, will not generalize to other settings or all conditions, and its implementation involves some major challenges.

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The Journal of the American Board of Family     Practice: 11 (2)
The Journal of the American Board of Family Practice
Vol. 11, Issue 2
1 Mar 1998
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Putting Population-Based Care Into Practice: Real Option or Rhetoric?
Stephen Taplin, Mary Sue Galvin, Tom Payne, David Coole, Ed Wagner
The Journal of the American Board of Family Practice Mar 1998, 11 (2) 116-126; DOI: 10.3122/15572625-11-2-116

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Putting Population-Based Care Into Practice: Real Option or Rhetoric?
Stephen Taplin, Mary Sue Galvin, Tom Payne, David Coole, Ed Wagner
The Journal of the American Board of Family Practice Mar 1998, 11 (2) 116-126; DOI: 10.3122/15572625-11-2-116
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