Association between licensing examination scores and resource use and quality of care in primary care practice.
Context. - Clinical competence is a determinant of the quality of care delivered, and may be associated with use of health care resources by primary care physicians.
Clinical competence is assumed to be assessed by licensing examinations, yet there is a paucity of information on whether scores achieved predict subsequent practice.
- To determine if licensing examination scores were associated with selected aspects of quality of care and resource use in initial primary care practice.
- Prospective cohort study of recently licensed family physicians, followed up for the first 18 months of practice.
- The Québec health care system.
- A total of 614 family physicians who passed the licensing examination between 1991 and 1993 and entered fee-for-service practice in Quebec.
Main Outcome Measures
- All patients seen by physicians were identified by the universal health insurance board and all health services provided to these patients were retrieved for the 18 months prior to (baseline) and after (follow-up) the physicians'entry into practice.
Medical service and prescription claims files were used to measure rates of resource use (specialty consultation, symptom-relief prescribing compared with disease-specific prescribing) and quality of care (inappropriate prescribing, mammography screening).
Baseline data were used to adjust for differences in practice population.
Mots-clés Pascal : Soin santé primaire, Médecin, Evaluation professionnelle, Activité professionnelle, Homme, Exploration, Canada, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Primary health care, Physician, Professional evaluation, Professional activity, Human, Exploration, Canada, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0446561
Code Inist : 002B30A09. Création : 25/01/1999.