Physician Performance in a Prepaid Health Plan

Results of the Peer Review Program of the Health Insurance Plan of Greater New York

Dados Bibliográficos

ID9103497
AutoresJeanne Magagna Deuschle (America's Health Insurance Plans, autor correspondente), Barbara Alvarez (0000-0002-5515-095X), Barbara A Alvarez (Hispanics in Philanthropy), Donald N Logsdon, William M Stahl (New York Medical College), Harry Smith (0000-0003-0922-5575, Icahn School of Medicine at Mount Sinai)
Ano1982
Volume20
Fascículo2
Páginas127-142
Data de publicação1982-02-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-198202000-00001
PMID7078277
OpenAlexW2057614087
IdiomaEN
Citações recebidas3

A peer review program to evaluate the quality of medical care was established by the Health Insurance Plan of Greater New York in 1973. Physician performance is assessed through application of explicit process criteria to medical care as recorded in the patient record. A total of 6,788 records were reviewed in terms of the clinical management of acute otitis media, hypertension and breast lesions. Follow-up procedures to bring about positive changes in delivery of health care were integrated into the program at the time of the initial audit. Reaudit of 715 records were used to measure change in physician compliance with medical care standards. Results of this audit/reaudit process demonstrated statistically significant improvement in quality of clinical practice as measured by the assessment parameters

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