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Using comparative clinical and economic outcome information to profile physician performance
M S Hendryx1, D S Wakefield, J F Murray
1Health Policy and Administration Program, Washington State University, Spokane, USA.
Health Services Management Research
|October 5, 1995
Summary
This study introduces methods for comparing physician performance using clinical and cost data, even with small patient groups. Objective outcome data helps identify physicians with better results and lower costs.
Area of Science:
- Health Services Research
- Medical Informatics
- Quality Improvement
Background:
- Evaluating physician performance is complex, especially with limited patient data and varying patient severity.
- Simultaneous assessment of clinical and economic outcomes is crucial for comprehensive performance evaluation.
Purpose of the Study:
- To present strategies and empirical examples for comparative physician profiling.
- To introduce a method for simultaneously evaluating clinical and cost outcomes.
- To compare physician economic and clinical performance using real-world data.
Main Methods:
- Utilized data from nine hospitals for inpatients treated between July 1990 and June 1992.
- Employed the MedisGroups clinical information management system for data abstraction.
- Focused on comparative total and ancillary adjusted charges, and patient morbidity status as main outcome measures.
Main Results:
- Objective comparative outcome data effectively assist in evaluating physician performance.
- Simultaneous comparison identified physicians with favorable outcomes at lower charges.
- The analysis also highlighted physicians with higher charges and/or poorer outcomes.
Conclusions:
- The presented strategies offer valuable insights for clinicians, governing boards, and third-party payors.
- These methods can support privileging and peer review activities within a Continuous Quality Improvement framework.
- Proactive application of these strategies can contribute to improving patient care and resource utilization.