Primary Care Physicians' Experiences With and Attitudes Toward Pediatric Quality Reporting

To assess primary care providers' experiences with and attitudes toward pediatric-focused quality reports and identify key associated physician/practice characteristics.

We performed a cross-sectional survey of pediatricians and family physicians providing primary care to publicly insured children in 3 states (North Carolina, Ohio, Pennsylvania). The survey included questions about receipt of pediatric quality reports, use of reports for quality improvement (QI), and beliefs about the effectiveness of reports for QI. We used multivariable analyses to assess associations between responses and physician/practice characteristics, including exposure to federally funded demonstration projects aimed at increasing quality reporting to physicians serving publicly insured children. We supplemented these analyses with a thematic investigation of data from 46 interviews with physicians, practice staff, and state demonstration staff.

Seven hundred twenty-seven physicians responded to the survey (overall response rate: 45.2%). Most physicians were receiving quality reports related to pediatric care (79.8%; 95% confidence interval [CI], 77.2%-82.4%) and believed that quality reports can be effective in helping guide QI (70.5%; 95% CI, 67.5%-73.5%). Fewer used quality reports to guide QI efforts (32.5%; 95% CI, 29.5%-35.6%). There were no significant associations between demonstration exposure and experiences or attitudes. Interview data suggested that physicians were receptive to quality reporting, but significant barriers remain to using such reports for QI, such as limited staff time or training in QI.

Although pediatric quality reporting is considered a promising strategy, in this study, state efforts appeared insufficient to overcome the barriers to using reports to guide practice-based QI.