- To describe quality assurance (QA) programs implemented by capitated physician groups ; to measure their relative emphasis on monitoring of overuse compared with underuse and monitoring and improving preventive services compared with chronic disease care ; and to examine how group characteristics influence QA activity.
- Cross-sectional questionnaire.
- A large network-model health maintenance organization in Califomia (133 contracting physician groups).
- Ninety-four physician groups (71%) caring for 2.9 million capitated patients.
- Self-reported use of quality monitoring and improvement methods.
- All capitated physician groups conducted some QA.
Groups'QA programs monitored areas subject to overuse, such as cesarean delivery and angioplasty rates, more than areas subject to underuse, such as childhood immunization rates and performance of retinal examinations for diabetic patients (64% vs 43%, P<. 001).
They monitored underuse of preventive services more than follow-up services for chronic diseases (54% vs 31%, P<. 001).
Groups also used reminders for preventive services more than they monitored follow-up services for chronic diseases (26% vs 15%, P<. 01).
Physician group characteristics independently associated with higher overall QA activity were greater number of years in existence, higher profitability, and capitated care penetration.
Mots-clés Pascal : Assurance qualité, Enquête, Médecin, Economie santé, Etats Unis, Amérique du Nord, Amérique, Dotation globale hospitalière
Mots-clés Pascal anglais : Quality assurance, Inquiry, Physician, Health economy, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0493739
Code Inist : 002B30A05. Création : 10/04/1997.