Evaluation of medical audit

Area of Science:

• Healthcare Management
• Clinical Quality Improvement
• Health Services Research

Background:

• Medical audit is a key tool for quality assurance in healthcare.
• Evaluating the overall effectiveness of medical audit programs is challenging.
• Most studies focus on specific interventions rather than comprehensive programs.

Purpose of the Study:

• To review existing knowledge on the effectiveness of medical audit programs.
• To assess specific interventions used within medical audits to change clinical behavior.
• To identify factors influencing the success of medical audit initiatives.

Main Methods:

• Systematic literature review of Medline-indexed articles (1985-1992).
• Inclusion of articles on "quality assurance" or "medical audit" and "evaluation".
• Exclusion of simple descriptions, replications, and non-English publications.

Main Results:

• Few evaluations assess entire medical audit programs; most focus on specific interventions.
• Interventions target patient characteristics, physician characteristics, organizational structures, or financial incentives.
• The scientific and technical aspects of quality are often the primary focus.

Conclusions:

• Current understanding of effective clinical behavior change methods via audit is limited.
• The impact of medical audits is highly context-dependent, hindering generalizability.
• Further qualitative research is needed to understand local factors influencing audit outcomes.