Changes in Physician Practice Patterns after Implementation of a Communication-and-Resolution Program

Autor:	Lorens A. Helmchen, Bruce L. Lambert, Timothy B. McDonald
Rok vydání:	2016
Předmět:	Male Chest Pain medicine.medical_specialty Chest pain 03 medical and health sciences Patient Admission 0302 clinical medicine Intervention (counseling) Humans Medicine 030212 general & internal medicine Practice Patterns Physicians' Program Development Propensity Score Data source Physician-Patient Relations Data collection Disclosure and Resolution Programs Medical Errors Practice patterns business.industry Communication 030503 health policy & services Health Policy Malpractice Liability Legal Middle Aged medicine.disease Patient Discharge Test (assessment) Emergency medicine Propensity score matching Female Medical emergency Principal diagnosis medicine.symptom 0305 other medical science business
Zdroj:	Health Services Research. 51:2516-2536
ISSN:	0017-9124
DOI:	10.1111/1475-6773.12610
Popis:	Objective To test if a 2006 communication-and-resolution program to address unexpected adverse outcomes was associated with changes in cost and use trajectories. Data source Records of patients discharged with a principal diagnosis of chest pain from 44 nonfederal general hospitals in Cook County, Illinois, between January 2002 and December 2009. Study design Propensity-score matched discharges from the intervention and comparison hospitals before computing difference-in-differences estimates of quarterly growth rates. Data collection methods We used discharge records submitted to a central statewide repository. Principal findings Relative to the comparison hospitals and to pre-implementation trends, and consistent with reduced testing at presentation, the intervention hospital recorded an increase in the number of patients with a principal diagnosis of chest pain. Among admitted patients, quarterly growth rates of clinical laboratory and radiology charges at the intervention hospital declined by 3.8 and 6.9 percentage points. Conclusions Among patients with chest pain, the implementation of a comprehensive communication-and-resolution program was associated with substantially reduced growth rates in the use of diagnostic testing and imaging services. Further research is needed to establish to what extent these changes were attributable to the program and clinically appropriate.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::469439b3386f0a6a21f9c5dd3674555e https://doi.org/10.1111/1475-6773.12610 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.