Applying case mix adjustment in profiling primary care physician performance.
This project was conducted with two objectives: developing a simple and meaningful performance efficiency index for profiling primary care physician (PCP) practice patterns and testing the explanatory power of the ambulatory care group case mix system in controlling for variation in patients' resource needs. The findings indicate that large administrative databases can provide valuable information for health services management. However, effort should be made to focus on methodological issues in analyzing those data sources. Conventional demographic risk adjustment factors (age and sex) are not adequate. Greater priority needs to be given to developing and applying additional risk adjustment systems to maximize the value of large administrative databases in profiling the relative efficiency of PCPs.
Chang
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W
Medical Management Department, Blue Cross Blue Shield of Iowa, Des Moines, USA.
McCracken
S B
SB
D000553:Ambulatory Care / Q000191:economics; D054598:Blue Cross Blue Shield Insurance Plans / Q000191:economics; D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups / Q000191:economics*; D006301:Health Services Needs and Demand / Q000191:economics; D006801:Humans; D007256:Information Systems; D007484:Iowa; D010818:Practice Patterns, Physicians' / Q000191:economics*; D011320:Primary Health Care / Q000191:economics*