Anemic inpatients. Correlates of house officer performance

To determine the correlates of the adequacy of the diagnostic evaluation of anemia, we conducted a prospective study on the medical services of a university-affiliated hospital. With the use of explicit criteria mapping techniques, the conditions of 204 (79%) anemic inpatients were adequately evaluated. By multiple regression analysis, the adequacy of evaluation showed significant correlations with the identity of the responsible house officer, the severity of the anemia, the patient's sex, and the service in which the patient received care. The performances of individual house officers were not significantly correlated with their subjective rankings by either their supervising residents or their attending faculty; however, a composite subjective ranking derived from the average of these two subjective rankings did correlate with objective performance in the anemia audit. We conclude that both patient and physician characteristics influence the adequacy of anemia evaluations and that objective audits may be a useful adjunct to the usual subjective methods for evaluating house officers' performances.