Related Experiment Videos
The relationship between resource constraints and physician problem solving. Implications for improving the process
M A Lescoe-Long1, M J Long, R L Amidon
1Department of Health Services Organization and Policy, Wichita State University, Kansas 67260-0043, USA.
Medical Care
|September 1, 1996
Summary
Resource constraints initially boost physician vigilance in problem-solving for acute myocardial infarction care. However, sustained vigilance only occurs when optimizing care directly reduces resource use, otherwise vigilance declines.
Area of Science:
- Clinical Decision-Making
- Healthcare Management
- Physician Behavior
Background:
- Physicians tend to be more vigilant problem-solvers when resources are limited.
- Vigilance in clinical strategies can lead to more optimal patient care choices.
Purpose of the Study:
- To investigate if resource constraints increase and sustain vigilance in cardiologists treating acute myocardial infarction.
- To analyze physician problem-solving strategies under varying resource conditions.
Main Methods:
- Reconstruction of physician problem-solving from medical records of acute myocardial infarction cases over six years.
- Utilizing the Herfindahl index to measure vigilant problem-solving across five tactical areas annually.
- Comparing physician activity during periods of resource slack versus resource constraints.
Main Results:
- Resource constraints initially increased physician vigilance in problem-solving.
- Sustained vigilance was observed in only one of the five tactical areas.
- Other areas showed reduced vigilance after an initial peak.
Conclusions:
- Resource constraints can improve clinical decision-making by promoting vigilance.
- Sustained vigilance is linked to clear optimization-reduction links in care strategies.
- Lack of a clear link between optimizing care and resource reduction leads to decreased vigilance and potential quality reduction.