Behavioral Effects of Audits in the Delivery of Health Care. Results from Exploratory Data Analysis.

Abstract

The 'Utilization Reviews' required under the Bennett Amendment to the Social Security Act of 1972 can be interpreted as 'independent audits' of the practices of medical professionals utilizing hospital services. This includes audit of patient-doctor relations by staff of an admitting hospital as well as audit of the hospital by an independent Professional Standards Review Organization. Implementation of this law was phased in a way that makes it possible to distinguish between 'audit anticipation' and 'audit occurrence' as separate aspects of 'audit per se' -- i.e., the 'audit process' as distinguished from any reports flowing from it. Using data on (1) Appendicitis and (2) Primary Cholecystectomy from a Boston area hospital, techniques from Exploratory Data Analysis are exploited to form hypotheses about the effects of these audits. The resulting hypotheses all suggest that the Utilization Reviews had significant effects on the behavior of medical professionals with respect to length of patient stay -- which were then confirmed by subsequent statistical (confirmatory) tests of the usual (classical) variety. Openings provided for further research on the use of audits as a means for managing the behavior of such personnel as medical professionals, research scientists, etc., are briefly indicated along with other new management tools that can be provided from such research. (Author)

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Document Details

Document Type
Technical Report
Publication Date
Jul 01, 1978
Accession Number
ADA060652

Entities

People

  • Neil C. Churchill
  • Vijayaraghavan Govindarajan
  • William W. Cooper

Organizations

  • Carnegie Mellon University

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Accounting
  • Auditing
  • Business Administration
  • Data Analysis
  • Data Science
  • Databases
  • Experimental Design
  • Health Care
  • Health Services
  • Hospitals
  • Hypotheses
  • Information Science
  • Medical Personnel
  • Personnel Management
  • Physicians
  • Standards
  • Statistical Analysis

Readers

  • Defense Financial Management and Audit.
  • Medical or Health Care Field.
  • Theoretical Analysis.