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Use of clinical practice guidelines in managed care physician groups
E Fang1, B S Mittman, S Weingarten
1Department of Medicine, University of California, Los Angeles School of Medicine, USA.
Archives of Family Medicine
|October 1, 1996
Summary
Most physician organizations develop or implement clinical guidelines for quality improvement and cost containment. Local expert opinion heavily influences development, with information feedback as the primary compliance method.
Area of Science:
- Health Services Research
- Medical Informatics
- Healthcare Management
Background:
- Growing interest in clinical guidelines for healthcare quality and cost-effectiveness.
- Limited data on guideline adoption by healthcare provider organizations.
Purpose of the Study:
- To investigate the development, implementation, and evaluation of clinical guidelines within physician organizations.
- To understand the influences and methods used in guideline adoption and compliance.
Main Methods:
- A written descriptive survey was administered to medical directors of physician groups and independent practice associations.
- The survey focused on the processes surrounding clinical guideline creation and use.
Main Results:
- 87% of surveyed organizations develop or implement clinical guidelines.
- Quality improvement and cost containment were primary drivers.
- Local expert opinion was the most significant influence on development.
- Information feedback was the most common method to increase compliance, with 19% using sanctions.
Conclusions:
- Physician organizations widely embrace clinical guidelines, often developing or adapting them locally.
- There is a notable gap in attention to guideline implementation and evaluation compared to development.