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)
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