L'impatto delle caratteristiche e dell'organizzazione dei Mmg sulla qualità assistenziale delle malattie croniche.

The aim of this paper are to estimate some indicators of quality of care for diabetes, heart failure, stroke and post-acute MI in the Local Health Trust of Bologna and to determine the appropriateness of management of these diseases in relation to the organizational structure of general practitioners (individual practices, practice associations, networks and group medicine). Multilevel logistic regression models were used to examine the relationship between organizational structure and quality of care indicators taking into account patient characteristics and comorbidity and physician characteristics. Indicators of good management were selected according to international guidelines. Group medicine was the most effective integration form of medical care for diabetes and post-IMA. From stroke, practice association was related to good performance.