Table 1.
Studies Comparing Generalists and Specialists in Terms of Knowledge, Patterns of Care, and Outcomes According to Disease State*
| Author | Ref. | Subject | n | Data† | Topic | Subject of Comparison |
|---|---|---|---|---|---|---|
| Acute myocardial infarction | ||||||
| Ayanian et al. | 25 | Physician | 1,211 | Self-report | Acute myocardial infarction | Knowledge, patterns of care |
| Hlatky et al. | 38 | Physician | 1,065 | Self-report | Acute myocardial infarction | Patterns of care |
| Hlatky et al. | 39 | Physician | 1,065 | Self-report | Acute myocardial infarction | Patterns of care |
| Jollis et al. | 40 | Patient | 8,241 | Medical record | Acute myocardial infarction | Patterns of care, outcomes |
| Patient | 220,535 | Administrative | Acute myocardial infarction | Patterns of care, outcomes | ||
| Ayanian et al. | 41 | Patient | 1,620 | Administrative and medical record | Acute myocardial infarction | Patterns of care, outcomes |
| Nash et al. | 42 | Patient | 40,684 | Administrative | Acute myocardial infarction | Patterns of care, outcomes |
| Other cardiovascular diseases | ||||||
| Friedmann et al. | 43 | Physician | 227 | Self-report | Hypercholesterolemia | Knowledge |
| Physician | 227 | Self-report | Systolic hypertension | Knowledge | ||
| Physician | 227 | Self-report | Coronary artery disease | Knowledge | ||
| Chin et al. | 49 | Physician | 727 | Self-report | Reduced ejection fraction | Patterns of care |
| Chin et al. | 52 | Patient | 214 | Medical record | Reduced ejection fraction | Patterns of care |
| Stafford et al. | 53 | Patient | 56,215 | Self-report | Hypercholesterolemia | Patterns of care |
| Young et al. | 54 | Physician | 235 | Self-report | Coronary artery disease | Patterns of care |
| Glassman et al. | 55 | Physician | 459 | Self-report | Synocope | Patterns of care |
| Physician | 459 | Self-report | Nonanginal chest pain | Patterns of care | ||
| Physician | 459 | Self-report | Nonspecific ECG changes | Patterns of care | ||
| Greenwald et al. | 56 | Physician | 3,000 | Self-report | Ischemic heart disease | Patterns of care |
| Physician | 3,000 | Self-report | Hypertension | Patterns of care | ||
| Schreiber et al. | 57 | Patient | 890 | Medical record | Unstable angina | Patterns of care, outcomes |
| Greenfield et al. | 58 | Patient | 532 | Direct patient assessment | Hypertension | Patterns of care |
| Patient | 1,296 | Direct patient assessment | Hypertension | Outcomes | ||
| Dermatologic diseases | ||||||
| Clark and Rietschel | 59 | Physician | 82 | Self-report | Skin diseases | Knowledge, patterns of care |
| Endocrine diseases | ||||||
| Greenfield et al. | 58 | Patient | 170 | Direct patient assessment | NIDDM | Patterns of care |
| Patient | 424 | Direct patient assessment | NIDDM | Outcomes | ||
| Gastrointestinal diseases | ||||||
| Fendrick et al. | 60 | Physician | 1,119 | Self-report | Helicobactor pylori | Knowledge |
| Mahajan et al. | 61 | Physician | 310 | Direct patient assessment | Gastrointestinal diseases | Patterns of care |
| Infectious diseases | ||||||
| Markson et al. | 20 | Patient | 2,433 | Administrative | AIDS | Patterns of care |
| Mauskopf et al. | 21 | Patient | 3,391 | Administrative | AIDS | Patterns of care |
| Morin et al. | 63 | Physician | 307 | Self-report | Cryptosporidiosis | Knowledge |
| Neurologic diseases | ||||||
| Mitchell et al. | 64 | Patient | 32,357 | Administrative | Acute stroke | Patterns of care, outcomes |
| Oncologic diseases | ||||||
| McFall et al. | 65 | Physician | 3,436 | Self-report | Breast cancer | Knowledge |
| Wachtel and Mor | 66 | Patient | 1,030 | Self-report | Terminal diseases | Patterns of care |
| Preventive care | ||||||
| Roetzheim et al. | 67 | Physician | 530 | Self-report | Mammography | Patterns of care |
| Lurie et al. | 68 | Physician | 680 | Administrative | Mammography | Patterns of care |
| 680 | Administrative | Pap smears | Patterns of care | |||
| Taplin et al. | 69 | Physician | 224 | Self-report | Breast exams | Patterns of care |
| 224 | Self-report | Mammography | Patterns of care | |||
| ACS | 14 | Physician | 1,035 | Self-report | Breast exams | Patterns of care |
| Physician | 1,035 | Self-report | Mammography | Patterns of care | ||
| Physician | 1,035 | Self-report | Pap smears | Patterns of care | ||
| Physician | 1,029 | Self-report | Breast exams | Patterns of care | ||
| Physician | 1,029 | Self-report | Mammography | Patterns of care | ||
| Physician | 1,029 | Self-report | Pap smears | Patterns of care | ||
| Grisso et al. | 70 | Physician | 298 | Self-report | Estrogen replacement | Patterns of care |
| Braun and Weisner | 22 | Physician | 549 | Self-report | Tuberculin testing | Patterns of care |
| Dietrich and Goldberg | 71 | Physician | 40 | Medical record | Preventive medical care | Patterns of care |
| Psychiatric diseases | ||||||
| Meredith et al. | 73 | Patient | 361 | Self-report and administrative | Depression | Patterns of care |
| Pulmonary diseases | ||||||
| Strauss et al. | 74 | Patient | 213 | Administrative and direct patient assessment | COPD | Patterns of care, outcomes |
| Zeiger et al. | 24 | Patient | 309 | Self-report, medical record, and direct patient assessment | Asthma | Patterns of care, outcomes |
| Vollmer et al. | 23 | Patient | 392 | Self-report | Asthma | Patterns of care, outcomes |
| Rheumatologic and orthopedic diseases | ||||||
| Bellamy et al. | 76 | Physician | 189 | Self-report | Gout | Patterns of care |
| Medellin et al. | 77 | Patient | 73 | Medical record | Gout | Patterns of care |
| Mazzuca et al. | 78 | Physician | 276 | Self-report | Osteoarthritis | Patterns of care |
| Mazzuca et al. | 79 | Patient | 419 | Direct patient assessment | Osteoarthritis | Patterns of care, outcomes |
| Walker et al. | 80 | Patient | 57 | Medical record | Acute monoarthritis | Patterns of care |
| Carey et al. | 81 | Patient | 825 | Self-report, medical record | Back pain | Patterns of care, outcomes |
| Shekelle et al. | 82 | Patient | 479 | Administrative | Back pain | Patterns of care |
*
ECG indicates electrocardiogram; NIDDM, non-insulin-dependent diabetes mellitus; ACS, American Cancer Society; COPD, chronic obstructive pulmonary disease.
†
Data for the reviewed studies were obtained from self-report (questionnaires and surveys), medical records, administrative records, and direct patient assessment (meaning subjects were evaluated solely for the purpose of the study by the researchers involved).