Jared Lane K Maeda1, Karen M Lee2, Michael Horberg3. 1. Research Scientist at the Mid-Atlantic Permanente Research Institute in Rockville, MD. jared.maeda@gmail.com. 2. Former Strategic Initiatives Manager for the Kaiser Foundation Research Institute in Oakland, CA. karen.michele.lee@gmail.com. 3. Executive Director of Research and Community Benefit for the Mid-Atlantic Permanente Research Institute in Rockville, MD. michael.horberg@kp.org.
Abstract
CONTEXT: Because of rising health care costs, wide variations in quality, and increased patient complexity, the US health care system is undergoing rapid changes that include payment reform and movement toward integrated delivery systems. Well-established integrated delivery systems, such as Kaiser Permanente (KP), should work to identify the specific system-level factors that result in superior patient outcomes in response to policymakers' concerns. Comparative health systems research can provide insights into which particular aspects of the integrated delivery system result in improved care delivery. OBJECTIVE: To provide a baseline understanding of comparative health systems research related to integrated delivery systems and KP. DESIGN: Systematic literature review. METHODS: We conducted a literature search on PubMed and the KP Publications Library. Studies that compared KP as a system or organization with other health care systems or across KP facilities internally were included. The literature search identified 1605 articles, of which 65 met the study inclusion criteria and were examined by 3 reviewers. RESULTS: Most comparative health systems studies focused on intra-KP comparisons (n = 42). Fewer studies compared KP with other US (n = 15) or international (n = 12) health care systems. Several themes emerged from the literature as possible factors that may contribute to improved care delivery in integrated delivery systems. CONCLUSIONS: Of all studies published by or about KP, only a small proportion of articles (4%) was identified as being comparative health systems research. Additional empirical studies that compare the specific factors of the integrated delivery system model with other systems of care are needed to better understand the "system-level" factors that result in improved and/or diminished care delivery.
CONTEXT: Because of rising health care costs, wide variations in quality, and increased patient complexity, the US health care system is undergoing rapid changes that include payment reform and movement toward integrated delivery systems. Well-established integrated delivery systems, such as Kaiser Permanente (KP), should work to identify the specific system-level factors that result in superior patient outcomes in response to policymakers' concerns. Comparative health systems research can provide insights into which particular aspects of the integrated delivery system result in improved care delivery. OBJECTIVE: To provide a baseline understanding of comparative health systems research related to integrated delivery systems and KP. DESIGN: Systematic literature review. METHODS: We conducted a literature search on PubMed and the KP Publications Library. Studies that compared KP as a system or organization with other health care systems or across KP facilities internally were included. The literature search identified 1605 articles, of which 65 met the study inclusion criteria and were examined by 3 reviewers. RESULTS: Most comparative health systems studies focused on intra-KP comparisons (n = 42). Fewer studies compared KP with other US (n = 15) or international (n = 12) health care systems. Several themes emerged from the literature as possible factors that may contribute to improved care delivery in integrated delivery systems. CONCLUSIONS: Of all studies published by or about KP, only a small proportion of articles (4%) was identified as being comparative health systems research. Additional empirical studies that compare the specific factors of the integrated delivery system model with other systems of care are needed to better understand the "system-level" factors that result in improved and/or diminished care delivery.
Authors: Michael Horberg; Leo Hurley; William Towner; Rebecca Gambatese; Daniel Klein; Diana Antoniskis; Winkler Weinberg; Peter Kadlecik; Carol Remmers; Robert Dobrinich; Charles Quesenberry; Michael Silverberg; Michael Johnson Journal: AIDS Patient Care STDS Date: 2011-01 Impact factor: 5.078
Authors: J Profit; J A F Zupancic; M C McCormick; D K Richardson; G J Escobar; J Tucker; W Tarnow-Mordi; G Parry Journal: Arch Dis Child Fetal Neonatal Ed Date: 2006-01-31 Impact factor: 5.747
Authors: David J Magid; P Michael Ho; Kari L Olson; David W Brand; Lesley K Welch; Karen E Snow; Anne C Lambert-Kerzner; Mary E Plomondon; Edward P Havranek Journal: Am J Manag Care Date: 2011-04 Impact factor: 2.229
Authors: Patrick R Finley; Heidi R Rens; Joan T Pont; Susan L Gess; Clifton Louie; Scott A Bull; Janelle Y Lee; Lisa A Bero Journal: Pharmacotherapy Date: 2003-09 Impact factor: 4.705
Authors: Justin W Timbie; Ashley M Kranz; Maria DeYoreo; Blen Eshete-Roesler; Marc N Elliott; José J Escarce; Mark E Totten; Cheryl L Damberg Journal: Health Serv Res Date: 2020-10-23 Impact factor: 3.402
Authors: Alexandra N Lea; Andrea Altschuler; Amy S Leibowitz; Tory Levine-Hall; Jennifer McNeely; Michael J Silverberg; Derek D Satre Journal: Addict Sci Clin Pract Date: 2022-02-09
Authors: Sarah Patricia Slight; Eta S Berner; William Galanter; Stanley Huff; Bruce L Lambert; Carole Lannon; Christoph U Lehmann; Brian J McCourt; Michael McNamara; Nir Menachemi; Thomas H Payne; S Andrew Spooner; Gordon D Schiff; Tracy Y Wang; Ayse Akincigil; Stephen Crystal; Stephen P Fortmann; David W Bates Journal: JMIR Med Inform Date: 2015-09-18