Using profiling for cost and quality management in the emergency department

Overutilization and underutilization of resources are inappropriate and may result in unacceptable quality of care and increased morbidity. Current data are needed to monitor the use of clinical resources and help identify physicians with appropriate cost/quality outcomes and those who may have utilization or quality problems. Profiling is an analytical tool that uses epidemiological method to compare cost, service use, and quality of various physician practice patterns for a large number of patient encounters. To develop a profiling program, standards of care must be established and information systems must be instituted to measure resource utilization and care efficiency. Such a program can be especially valuable in the emergency department of hospitals, where wide variation in practice patterns may occur because of the episodic nature of patient encounters. A reduction in practice variations saves time and increase patient throughput in many cases.