What question did this study set out to answer?

To investigate whether patient panel demographic, clinical, and socioeconomic characteristics influence relative primary care physician performance rankings in an academic healthcare network.

September 7, 2010JAMA

Relationship Between Patient Panel Characteristics and Primary Care Physician Clinical Performance Rankings

View Full Paper

Ask AI

Bookmark

Authors

CHClemens S. HongLos Angeles County Department of Health Services

Discussion

Member takes

Implication

Cohort study reveals patient demographics and insurance status significantly affect primary care physician performance rankings, indicating quality scores reflect patient vulnerability.

Key Points

To investigate whether patient panel demographic, clinical, and socioeconomic characteristics influence relative primary care physician performance rankings in an academic healthcare network.
Cohort study analyzing data from 125,303 adult patients treated by 162 primary care physicians across 9 hospital-affiliated practices and 4 community health centers between 2003 and 2005.
Calculated composite physician performance scores based on 9 HEDIS quality measures and evaluated rank shifts after adjusting for practice site, visit frequency, and patient panel characteristics.
Physicians in the lowest quality tertile cared for significantly higher proportions of minority (25.6% [95% CI, 20.2%-31.1%] vs 13.7% [95% CI, 10.6%-16.7%]; P < .001), non-English-speaking (10.2% [95% CI, 5.5%-14.9%] vs 3.2% [95% CI, 0.7%-5.6%]; P < .001), and Medicaid or uninsured patients (17.2% [95% CI, 13.5%-21.0%] vs 9.6% [95% CI, 7.5%-11.7%]; P < .001) compared to top-tertile physicians.
Patients of top-tertile physicians were older (51.1 years [95% CI, 49.6-52.6] vs 46.6 years [95% CI, 43.8-49.5]; P < .001), had more comorbidities (0.91 [95% CI, 0.83-0.98] vs 0.80 [95% CI, 0.66-0.95]; P = .008), and had more frequent visits (>3 visits/year: 71.0% vs 61.8%; P = .003).
Adjusting for patient panel factors produced a mean physician rank change of 7.6 percentiles (95% CI, 6.6-8.7 percentiles), reclassifying 36% (59/162) of physicians into different quality performance tertiles.

Cite This Study

Clemens S. Hong (2010) studied this question.

synapsesocial.com/papers/6a0c6612d48675e494236758 https://doi.org/10.1001/jama.2010.1287

View Full Paper

Ask AI

Bookmark

Implication

Cohort study reveals patient demographics and insurance status significantly affect primary care physician performance rankings, indicating quality scores reflect patient vulnerability.

Relationship Between Patient Panel Characteristics and Primary Care Physician Clinical Performance Rankings

Discussion

Member takes

Implication

Key Points

Cite This Study

Relationship Between Patient Panel Characteristics and Primary Care Physician Clinical Performance Rankings

Discussion

Member takes

Implication

Key Points

Cite This Study

Also Consider

Also Consider