ArticleHealth services research2020
Are health systems redesigning how health care is delivered?
Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed.
- Community Characteristics Associated With Health System Penetration.Medical care research and review : MCRR · 2026Article
- Primary Care Physician Organization Affiliations With Health Systems Between 2014 and 2019 Were Associated With Modest Improvements in Quality of Care.Medical care research and review : MCRR · 2026Article
- Health System Integration and Prior Authorization in Medicare Advantage.Health services research · 2026Article
- The Structural Imbalance and Trajectory of Chinese National Policies on Medical-Preventive Integration: A Three-Dimensional Analysis of Policy Instruments (2015-2025).Healthcare (Basel, Switzerland) · 2026Article
- Redesigning Mental Health Care: Core Principles for Integrating Systems, Technology and Clinical Workflows.Current psychiatry reports · 2026Review
- From Co-Design to Quality Improvement: Using the Double Diamond Framework to Develop Primary Care Redesign Priorities for Hypertension Care.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Health System Affiliation and Care for Dual-Eligible and Non-Dual-Eligible Medicare Beneficiaries.JAMA network open · 2025Article
- A Policy and Regulatory Framework to Promote Care Delivery Redesign and Production Efficiency in Health Care Markets.The Milbank quarterly · 2025Article
- Mortality Among Older Medical Patients at Flagship Hospitals and Their Affiliates.Journal of general internal medicine · 2024Article
- Making integration work.Health services research · 2020Article
- Are health systems redesigning how health care is delivered?Health services research · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectiveTo explore why and how health systems are engaging in care delivery redesign (CDR)-defined as the variety of tools and organizational change processes health systems use to pursue the Triple Aim. STUDY
settingA purposive sample of 24 health systems across 4 states as part of the Agency for Healthcare Research and Quality's Comparative Health System Performance Initiative. STUDY
designAn exploratory qualitative study design to gain an "on the ground" understanding of health systems' motivations for, and approaches to, CDR, with the goals of identifying key dimensions of CDR, and gauging the depth of change that is possible based on the particular approaches to redesign care being adopted by the health systems. DATA COLLECTION: Semi-structured telephone interviews with health system executives and physician organization leaders from 24 health systems (n = 162). PRINCIPAL
findingsWe identify and define 13 CDR activities and find that the health systems' efforts are varied in terms of both the combination of activities they are engaging in and the depth of innovation within each activity. Health system executives who report strong internal motivation for their CDR efforts describe more confidence in their approach to CDR than those who report strong external motivation. Health system leaders face uncertainty when implementing CDR due to a limited evidence base and because of the slower than expected pace of payment change.
conclusionsThe ability to validly and reliably measure CDR activities-particularly across varying organizational contexts and markets-is currently limited but is key to better understanding CDR's impact on intended outcomes, which is important for guiding both health system decision making and policy making.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.