Integrated Care from the Patient's Perspective and its Relationship to Medical Group Attributes.

Integrating care for patients with multiple chronic conditions is essential to improving quality. Yet little is known about care integration from the patient’s perspective and how it relates to medical group characteristics. We created a nationally representative dataset that links patient survey to medical group data and analyzed relationships using ordered logistic regression. We administered the Patient Perceptions of Integrated Care (PPIC) survey across a stratified random sample of 150 medical groups including 12,364 Medicare beneficiaries with multiple chronic conditions, with a final sample of 3,067 respondents (26% after exclusions). Medical group data from the National Study of Physician Organizations included group size, ownership, specialty mix, information technology capabilities, and care management processes. Among integrated care constructs, the most positive responses were for Test Result Communication. The most negative were for Support for Self-directed Care and Support for Medication and Home Health Management. Patient perceived integration was consistently more positive for multi-specialty groups. Integrated care was positively albeit inconsistently related to large size, surprisingly negatively related to IT capabilities and care management processes, and weakly related to hospital ownership. This study presents new measures of care integration that are valid, reliable and comprehensive, and identifies opportunities to better integrate care.