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papers

Profiling primary care physician resource use: examining the application of case mix adjustment

Published: January 1, 1996
Category: Papers
Authors: Honigfeld S, Parton RA, Tucker AM, Weiner JP
Country: United States
Language: null
Type: Care Management
Setting: Academic

J Ambul Care Manage 19:60-80.

Health Services Research and Development Center, Johns Hopkins School of Public Health, Baltimore, MD, USA

Growing emphasis on managed care has led to increased interest in physician practice profiling. Standardized techniques for conducting profiling are not yet well established. One particularly challenging methodologic issue, case mix adjustment, is explored here using actual cost profiles derived from primary care physicians at two independent practice association (IPA)-model health maintenance organizations (HMOs). Specifically, this article examines how the ambulatory care group case mix methodology can be applied to profiling and illustrates that it provides more depth of information with which to assess performance than does standard demographic adjustment alone. This analysis suggests both the potential and methodologic limitations of profiling at the individual physician level.

Comment in
J Ambul Care Manage. 1996 Jan;19(1):81-5.
J Ambul Care Manage. 1996 Jan;19(1):86-9.

PMID: 10154370

Practice Patterns Comparison,Resource Use,Cost Burden Evaluation,United States,Ambulatory Care/statistics & numerical data,Ambulatory Care/utilization,Data Collection,Diagnosis-Related Groups/economics,Diagnosis-Related Groups/statistics & numerical data,Fees,Medical/statistics & numerical data,Health Resources/utilization,Health Services Research/methods,Physicians,Family/economics,Utilization Review/methods

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