title: Using comparative clinical and economic outcome information to profile physician performance.
abstract: This paper presents strategies and empirical examples of comparative physician profiling under conditions of limited patient sample sizes and varying patient severity. A method by which clinical and cost outcomes may be evaluated simultaneously is also presented. Physician economic and clinical performance are compared using data abstracted from nine hospitals into the MedisGroups clinical information management system for inpatients treated from July, 1990 through June, 1992. The main outcome measures are comparative total and ancillary adjusted charges, and morbidity status. Results suggest that objective comparative outcome data provide useful information to assist in evaluating physician performance. A simultaneous comparison of clinical outcomes and adjusted charges identifies physicians who experience favorable outcomes at lower charges, as well as those who have higher charges and/or poorer outcomes. Strategies outlined in this paper may be of value to clinicians, governing boards, and third party payors. These strategies may be used to assist with privileging and other peer review activities when pursued proactively within a Continuous Quality Improvement framework to improve care.
authors.affiliation: Health Policy and Administration Program, Washington State University, Spokane, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Hendryx
authors.forename: D S
authors.initials: DS
authors.lastname: Wakefield
authors.forename: J F
authors.initials: JF
authors.lastname: Murray
authors.forename: T
authors.initials: T
authors.lastname: Uden-Holman
authors.forename: C M
authors.initials: CM
authors.lastname: Helms
authors.forename: R L
authors.initials: RL
authors.lastname: Ludke
mesh_terms: D000720:Ancillary Services, Hospital / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups; D017722:Hospital Charges; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008505:Medical Staff, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D009017:Morbidity; D017063:Outcome Assessment, Health Care / Q000592:standards / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D011787:Quality of Health Care; D017749:Total Quality Management