Changes in tonsillectomy rates associated with feedback and review.
Changes in tonsillectomy rates associated with feedback and review.
复制标题
扁桃体切除率的变化与反馈和审查相关。
DOI：
10.1542/peds.59.6.821
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发表时间：
1977
期刊：
影响因子：
8
通讯作者：
Alan Gittelsohn
中科院分区：
文献类型：
--
作者：
John E. Wennberg;Lewis Blowers;Robert A. Parker;Alan Gittelsohn
在佛蒙特州的13个医院服务区中，扁桃体切除术的比率在五年内有所下降。1969年，有7个地区的失业率超过了美国估计的全国失业率；到1973年，所有地区的平均失业率下降了46%，只有一个地区的失业率仍然高于美国。大部分变化发生在向佛蒙特州医学会反馈数据显示1969年的变化之后。在13个领域中，有12个领域的反馈与临床实践变化之间的关系无法记录下来；然而，比率最高的地区的医生审查了扁桃体切除术的适应症，并采用了第二种意见程序来审查手术候选人。经验表明，以人口为基础的数据对程序发生率的反馈可能是同行审查进程的宝贵工具。
Among 13 Vermont Hospital Service Areas, tonsillectomy rates decreased over a five-year period. In 1969, the rates in seven areas exceeded the estimated United States national rate; by 1973, the average rate for all areas had declined 46% and only one area remained above the U.S. rate. Much of the change occurred after feedback of data to the Vermont State Medical Society demonstrating 1969 variations. In 12 of the 13 areas, the relationship between feedback and change in clinical practices could not be documented; however, physicians in the area with the highest rate reviewed the indications for tonsillectomy and adopted a second opinion procedure for reviewing candidates for the surgery. The experience suggests that feedback of population-based data on incidence of procedures may be a valuable tool for the peer review process.