Discretionary Decision Making By Primary Care Physicians And The Cost Of U.S. Health Care
| Autor: | Patricia M. Gallagher, Elliott S. Fisher, Brenda E. Sirovich, David E. Wennberg |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Screening test media_common.quotation_subject Decision Making Psychological intervention Primary care Article Ambulatory care Nursing Health care medicine Humans Quality (business) Practice Patterns Physicians' media_common Primary Health Care business.industry Health Policy Physicians Family Health Care Costs Health Services Clinical judgment United States Health Care Surveys Family medicine Hypertension Self care business |
| Zdroj: | Health Affairs. 27:813-823 |
| ISSN: | 1544-5208 0278-2715 |
| DOI: | 10.1377/hlthaff.27.3.813 |
| Popis: | Efforts to improve the quality and costs of U.S. health care have focused largely on fostering physician adherence to evidence-based guidelines, ignoring the role of clinical judgment in more discretionary settings. We surveyed primary care physicians to assess variability in discretionary decision making and evaluate its relationship to the cost of health care. Physicians in high-spending regions see patients back more frequently and are more likely to recommend screening tests of unproven benefit and discretionary interventions compared with physicians in low-spending regions; however, both appear equally likely to recommend guideline-supported interventions. Greater attention should be paid to the local factors that influence physicians' clinical judgment in discretionary settings. |
| Databáze: | OpenAIRE |
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