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Related Experiment Videos

A cost-effective method to characterize variation in clinical practice.

K Chang1, S Sauereisen, M Dlutowski

  • 1Jefferson Medical College, USA.

Evaluation & the Health Professions
|November 11, 1999
PubMed
Summary

Physician practice variation in asthma, heart failure, and diabetes care was measured. A brief survey identified inconsistent practices and overuse of tests, suggesting a cost-effective method for assessing and improving clinical care.

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Area of Science:

  • Medical Practice
  • Health Services Research
  • Clinical Guidelines

Background:

  • Physician practice styles and policies exhibit significant variation.
  • Understanding this variation is crucial for improving healthcare quality and efficiency.
  • Evidence-based medicine adoption and adherence to clinical guidelines are key areas of interest.

Purpose of the Study:

  • To measure practice style and policy variations among family physicians and general internists.
  • To assess physician adherence to evidence-based medicine in specific clinical areas.
  • To evaluate the utility of a brief survey for assessing practice variation.

Main Methods:

  • A survey was administered to family physicians and general internists.
  • Questions focused on evidence-based medicine in asthma, congestive heart failure, and diabetes mellitus.

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  • Items also addressed clinical recommendations amid uncertain standards and managed care.

    • Main Results:

    • Significant variation in responses was observed for 20 out of 36 items.
    • Some physician responses aligned with established practice guidelines.
    • A tendency towards overuse of expensive diagnostic tests was noted.

    Conclusions:

    • A brief, open-ended survey is a quick and economical method to assess practice variation.
    • This survey approach offers an alternative to costly medical record or claims data analyses.
    • Validated surveys can establish baselines for interventions and measure their impact on practice styles.