Abstract
Group care models, in which patients with similar health conditions receive medical services in a shared appointment, have increasingly been adopted in a variety of health care settings. Applying the Triple Aim framework, we examined the potential of group medical care to optimize health system performance through improved patient experience, better health outcomes, and the reduced cost of health care. A systematic review of English language articles was conducted using the Cochrane Controlled Trials Register (CENTRAL), MEDLINE/PubMed, Scopus, and Embase. Studies based on data from randomized control trials (RCTs) conducted in the US and analyzed using an intent-to-treat approach to test the effect of group visits versus standard individual care on at least one Triple Aim domain were included. Thirty-one studies met the inclusion criteria. These studies focused on pregnancy (n = 9), diabetes (n = 15), and other chronic health conditions (n = 7). Compared with individual care, group visits have the potential to improve patient experience, health outcomes, and costs for a diversity of health conditions. Although findings varied between studies, no adverse effects were associated with group health care delivery in these randomized controlled trials. Group care models may contribute to quality improvements, better health outcomes, and lower costs for select health conditions.
Highlights
This paper focuses on the use of group care models for prenatal care and the management of chronic health conditions, which have received the most attention in the scientific literature, to synthesize the evidence generated from randomized controlled trials (RCT)
The included studies used data from RCTs conducted in the United States (US), were analyzed with an intent-to-treat approach to test the effect of group visits versus standard individual care, and included outcome variables related to at least one of the following Triple Aim dimensions: (1) patient experience, measured by patient satisfaction, adequacy and comprehensiveness of care, and perceived health status and quality of life; (2) health outcomes, measured by clinical outcomes and health behaviors; and (3) cost, measured by health care expenditures and additional service utilization [17]
These studies focused on pregnancy (n = 9), diabetes (n = 15), and other chronic health conditions (n = 7)
Summary
In which patients with similar health conditions receive medical services in a shared appointment, have increasingly been adopted in a variety of health care settings in the United States (US) due to their potential to enhance health care value [1]. Group visits are conducted by a medical provider with billing privileges who may be supported by another health or social service provider (e.g., nurse, pharmacist, social worker, community health worker), enabling more comprehensive and integrated care [2]. Group care models are theorized to yield benefits for patients through increased provider contact time, expanded education, social support among participants, building social norms for healthy behaviors within groups, and the opportunity to develop more equitable relationships with providers [3]
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