Results of a radiology performance report for a health maintenance organization.
OBJECTIVE
To present results with a radiology performance report to help evaluate utilization of radiologic examinations by primary-care practices (family practice, internal medicine, or pediatrics) in an independent practice association health maintenance organization (HMO).


METHODS
Utilization reports for primary-care-physician practices (n = 5,000) over a 12-month period (July 1, 1993 through June 30, 1994) were derived from administrative data collected from claim and encounter forms submitted by radiologic practices. Data were divided into 22 measures to help define practice utilization. five overall measures helped evaluate procedures performed by HMO member or nonmember practices per 1,000 members. Twelve specific measures helped evaluate patterns of use of frequently ordered imaging procedures (eg, computed tomography, magnetic resonance imaging, bone scanning, cardiovascular nuclear imaging, nonobstetric ultrasound, and plain radiography). Five quality measures helped evaluate utilization of screening mammography in women aged 50-64 years (as a percentage of all women in the HMO aged 50-64 years) and of low-yield examinations (ie, sinus, rib, and skull radiography per 1,000 adult members).


RESULTS
Individual practice utilisation mean results were compared with overall HMO mean results adjusted for practice type and age and sex of members.


CONCLUSIONS
Utilization data are an integral part of evaluation of HMOs and their providers, and these results helped establish a baseline level of performance.
Kessler
H B
HB
Department of Diagnostic Imaging, Fox Chase Cancer Center, Philadelphia, Pa, USA.
Hanchak
N A
NA
McDermott
P D
PD
Hirsch
A
A
Meeh
S
S
D000328:Adult; D002204:Capitation Fee; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D010372:Pediatrics / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D011785:Quality Assurance, Health Care; D011859:Radiography / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D015895:Relative Value Scales; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data