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Conclusions: Large variations between guidelines have been observed which would translate in large practice variations, if the guidelines were systematically applied.
This evidence could imply the need for changing our guidelines, which may cause a shift in large practice variation to evidence based primary treatment for these women.
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Physicians in small physician-owned practices in the United States have been slower to adopt EHRs than physicians in large practices or practices owned by large organizations.
As opposed to our expectation, we found little evidence for better performance in large practices.
Poor recruitment (<5% of CTA-identified EPRs) was more common in large practices (n = 7) than small practices (n = 1).
Patients in the two arms were similar in all respects, except that a higher percentage of usual care arm patients were in large practices (106 (54%) v 70 (37%)).
In addition, we found that patients consulting PCPs working in large practices were also more demanding, which could explain why they tended to report lower satisfaction ratings.
Physicians most likely to be subject to quality incentives worked in staff-model or group-model health maintenance organizations or in large practices (>50 physicians).
Another explanation may be that patients consulting PCPs working in large practices are more demanding, as suggested by our results assessing patients' expectations.
Furthermore, more GPs displayed transient care if parented nominated them as working in large practices compared to small practices (mean 3.3 versus 2.1 GPs per practice, t-value = -3.81, df = 132 p < 0.001).
In the separate analyses of consultation length, a negative main effect for list size was found in small as well as in large practices, but only in the latter was this coefficient statistically significant.
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CEO of Professional Science Editing for Scientists @ prosciediting.com