In 2011, the California Right Care Initiative implemented a countywide physician organization learning collaborative called University of Best Practices (UBP) in San Diego County for major health care systems and physician organizations to share best practices in managing cardiovascular and cerebrovascular risk factors.

The authors' objective was to examine whether UBP was associated with fewer hospitalizations for heart attacks and strokes. Authors used a quasi-experimental design to compare age-adjusted adult hospitalization rates before UBP initiation (2007-2010) against rates after UBP initiation (2011-2014) in San Diego County versus the rest of California. Difference-in-differences (DID) logistic regression models were estimated using hospitalization data from the California Office of Statewide Health Planning and Development for 2007 to 2014, including 372,205 and 642,455 hospitalizations for heart attacks and strokes, respectively. California Health Interview Survey county-level data were used for control variables for the following indicators: percentage of the adult population that did not have health insurance, the percentage that did not have a usual place to go when sick or needing health advice, and the percentage that had an income from 0% to 199% of the federal poverty level because these factors are associated with the ability to pay for health care services and access to care.

Findings: Authors found in the UBP versus pre-UBP period, the odds of adults being hospitalized for a heart attack in San Diego County decreased, whereas the odds stayed the same for adults in the rest of California. This relative decrease was equivalent to 2,735 (or 16.5%) fewer hospitalizations, totaling $61 million (2014 dollars). No robust association was found between UBP implementation and hospitalizations for strokes.