Can Planned Visit Scores Predict Practice Improvements in Patient Experience Outcomes? A Meta-Regression Study

• Activity Number: 504
• Type: Contributed
• Date/Time: Wednesday, August 6, 2014 : 10:30 AM to 12:20 PM
• Sponsor: Health Policy Statistics Section
• Author(s): Gerald Arnold*+ and Rebecca Baranowski and Lauren Duhigg
• Companies: American Board of Internal Medicine and American Board of Internal Medicine and American Board of Internal Medicine
• Keywords: Planned Visits ; Chronic Care Model ; Meta-regression ; patient experience measures ; Spearman correlation ; Effect size

Abstract

Planned visits protocols (PVP) help care teams treat chronic care patients: patients receive evidence-based care and self-management training. Practices completing PVP received better patient-experience scores (PROM) than matched-controls: PROM in PVP practices were higher in involving patients in care plans (p=.005) and helpful and courteous staff (p< .001). Study used 1,402 internists. Physicians completed ABIM Practice Improvement Module® on physician communication. Patients used CAHPS-based surveys. Patients:13,699, baseline and 12,646, follow-up. 201 physicians reported PVP; controls: 1,201 practices without PVP. PROM: physician communication (PC: Cronbach a=.87); shared decision-making (SDM: a = .65); staff helpfulness/courteousness (SHC: a=.84); lab results follow-up (LF: a= .86); and overall physician rating (OR: a=.89). Compared quality effect sizes (ES):practices with PVP or not. Dependent variable: Practice ES; predictors: planned-visit (PV) score, PVP dummy, and interaction. PV score predicts PC (p=.01), SHC (p=.03), LF (p=.03), and OR (p=.03); not predictive of SDM (p=.33). Results apply to minimally important differences in PROM at practice or physician levels.