Improving physicians' preventive health care behavior through peer review and financial incentives.
We assessed improvement of preventive health care behaviors by physicians in an independent practice association-health maintenance organization. A before-after, 3-year study of a defined cohort measured changes through chart audit, accompanied by peer review, feedback, and financial incentives. Outcome measures consisted of rates of mump-measles-rubella (MMR) immunization, screening for cholesterol levels, and charting adequacy. Offices meeting MMR vaccination standards over 3 years increased from 78% to 96% (P < .05); those meeting standards for screening for cholesterol levels, from 92% to 95%. The average scores for charting adequacy rose from 87% to 92% (P < .05). The percentage of practices not in compliance with a standard of 90% decreased as follows: for MMR vaccination, from 57% to 12%; for screening for cholesterol levels, from 21% to 11%; and for charting adequacy, from 53% to 29% (P < .05).
Morrow
R W
RW
Department of Family Medicine, St Josephs Medical Center, Yonkers, NY.
Gooding
A D
AD
Clark
C
C
D002784:Cholesterol / Q000097:blood; D005246:Feedback; D006279:Health Maintenance Organizations / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D008485:Medical Audit; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012052:Reimbursement, Incentive; D014481:United States
D002784:Cholesterol