Do report cards score with patients and doctors?

Area of Science:

• Health Services Research
• Medical Quality Improvement
• Diabetes Care Management

Background:

• Physician profiling, using report cards, is a strategy to assess and improve healthcare quality.
• Evaluating physician performance based on patient outcomes is complex and faces methodological challenges.

Purpose of the Study:

• To assess the reliability of physician report cards in detecting practice variations for diabetes care.
• To identify limitations in using patient outcomes for evaluating physician performance.

Main Methods:

• The study analyzed data from a U.S. Agency for Health Care Policy and Research-sponsored project.
• Physician performance was evaluated using report cards focusing on diabetes patient outcomes across different practice types.

Main Results:

• Physician report cards for diabetes care were unreliable in distinguishing true practice differences among physicians.
• The limited number of diabetic patients managed by individual physicians was a significant factor in the lack of reliable outcome detection.
• Profiling methods may create incentives for physicians to avoid patients with complex or high-cost conditions.

Conclusions:

• Current physician profiling methods for diabetes care may not accurately reflect physician practice variations.
• The small patient populations in many practices limit the effectiveness of outcome-based physician evaluations.
• Physician profiling linked to incentives could negatively impact care for patients with challenging health conditions.