MEASURING THE EFFICENCY OF HEALTH CARE PROVIDERS

衡量医疗保健提供者的效率

• 批准号: 7222404
• 负责人: ELLIOTT S FISHER
• 金额: $ 24.46万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-12-01 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7222404
• 关键词: Address; Adult; Agreement; American; Attention; Board Certification; Caring; Certification; Clinical; Country; Data; Environment; Exhibits; Family Physicians; Family Practice; Goals; Health; Health Care Costs; Health Personnel; Healthcare; Healthcare Systems; Hospitals; Individual; Internal Medicine; Internist; Investments; Judgment; Knowledge; Learning; Legal; Link; Maintenance; Measurement; Measures; Medical; Medical Staff; Medicare; Numbers; Outcome; Patient Care; Patients; Performance; Physicians; Primary Care Physician; Private Sector; Provider; Quality of Care; Relative (related person); Resources; Role; Safety; Sample Size; Score; Surveys; System; Techniques; Training; Variant; Work; beneficiary; billing data; cost; health care service organization; improved; insight

Evidence that higher health care spending across US regions is associated with lower quality and no gains in health outcomes suggest substantial opportunities to improve the efficiency of U.S. health care. Achieving improvements, however, will be difficult due to the lack of actionable measures and of quality and resource use - and insufficient knowledge about the determinants of efficiency - at the physician, physician group, and hospital levels. This project will address the following specific aims: Aim 1. Develop and implement measures that can be used to assess the efficiency of physicians, physician groups, and hospitals. We will draw on routinely collected data to develop and implement provider-specific clinical performance measures. Because small sample sizes seriously limit the number of providers who can be reliably measured, we will apply statistical filtering with empirical Bayes techniques to improve the precision of our measures. Aim 2. Explore the determinants of efficiency at the individual physician level. We have agreements in place to obtain board certification exam scores from the American Board of Internal Medicine and American Board of Family Medicine. We will link individual physicians' exam scores to the clinical performance measures developed under Aim 1 as well as with measures that characterize the settings where they trained and where they now practice. These data will be used to address the question: what makes a good doctor? Aim 3. Explore the determinants of efficiency for physician groups and hospitals. We will draw on the extensive measures developed under Aims 1 and 2 - and through our proposed national survey of physicians - to identify factors associated with improved efficiency at two organizational levels: the hospital itself and the "extended medical staff' (physicians who either work within a specific hospital or whose patients are admitted to these hospitals). The goal of this project is to provide measures and insights at the levels of individual physicians, physician groups, and hospitals that should prove useful in efforts to improve the efficiency of the US health care system.

有证据表明，美国各地区较高的医疗保健支出与较低的质量和没有收益相关 健康结果表明有大量机会提高美国医疗保健的效率。实现 然而，由于缺乏可行的措施以及质量和资源，改进将很困难 医生、医生团队的使用以及对效率决定因素的了解不足 和医院级别。该项目将实现以下具体目标： 目标 1. 制定并实施可用于评估医生效率、医生效率的措施 团体、医院。我们将利用定期收集的数据来开发和实施特定于提供商的 临床表现测量。因为样本量小严重限制了能够提供服务的提供商数量 为了可靠地测量，我们将应用经验贝叶斯技术的统计过滤来改进 我们措施的精确度。 目标 2. 探索个体医生层面效率的决定因素。我们已达成协议 获得美国内科医学委员会和美国委员会的委员会认证考试成绩 家庭医学。我们将把个别医生的考试成绩与临床表现衡量指标联系起来 根据目标 1 制定，并采取措施来描述他们接受培训和培训的环境 他们现在练习的地方。这些数据将用于解决以下问题：什么才是好医生？ 目标 3. 探索医生团体和医院效率的决定因素。我们将借鉴 根据目标 1 和 2 并通过我们提议的全国调查制定了广泛的措施 医生 - 确定与两个组织层面提高效率相关的因素：医院 本身和“扩展医务人员”（在特定医院工作或在其医院工作的医生） 患者被收治在这些医院）。 该项目的目标是在个体医生、医生和医生的层面上提供测量和见解。 应该证明对提高美国医疗保健效率有用的团体和医院 系统。