Physician Provider Profiling in Brooke Army Medical Center's Internal Medicine Clinic: A Multiple Regression and Process Control Model
Abstract
The purpose of this project is to develop a model and tool that utilizes data currently capture by existing information systems to apply objective metrics for physician provider practice profiling. The model examines utilization expense for lab, x-ray and pharmacy services ordered for outpatients in Brooke Army Medical Center's Internal Medicine Clinic during the 3rd & 4th quarter of FY 1998. Data regarding 26,502 individual patient-provider encounters were extracted from both the Composite Health Care System (CHCS) and Ambulatory Data System (ADS) computer databases. Data extracts were then loaded into a PC database management system for subsequent relational integration, organization and statistical analysis. Case-mix adjustment was accomplished by selecting internists and internal medicine residents and a single primary diagnosis. Second level case mix adjustment accounted for other quantifiable variables using a multiple regression model identify% variables having a statistically significant relationship with the total ancillary expense. Variables accounted for diversity among patients, providers, and individual encounter acuity. Profiling was accomplished showing dispersion of lab, x-ray and pharmacy expense for each provider as predicted by the multiple regression model. Significant variables were patient beneficiary category, number of comorbid diagnoses, and the consistency of seeing the same provider; significant provider variables were professional status and experience. A surprising finding was that neither patient age, sex, or RVU intensity were significant determinants of expense.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 01, 1999
- Accession Number
- ADA420371
Entities
People
- Michael D. Wegner
Organizations
- Academy of Health Sciences