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Changes in Physician Practice Patterns after Implementation of a Communication-and-Resolution Program.

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Citation: Health Services Research. 51 Suppl 3:2516-2536, 2016 DecPMID: 27892622Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Communication | *Liability, Legal | *Medical Errors/px [Psychology] | *Practice Patterns, Physicians' | Chest Pain/di [Diagnosis] | Chest Pain/th [Therapy] | Female | Humans | Male | Malpractice/sn [Statistics & Numerical Data] | Medical Errors/sn [Statistics & Numerical Data] | Middle Aged | Patient Admission/sn [Statistics & Numerical Data] | Patient Discharge/sn [Statistics & Numerical Data] | Physician-Patient Relations | Practice Patterns, Physicians'/sn [Statistics & Numerical Data] | Program Development | Propensity ScoreYear: 2016 Local holdings: Available online through MWHC library: 2013 to the present, Available in print through MWHC library: 1999 - 2005ISSN:

0017-9124

Name of journal: Health services researchAbstract: CONCLUSIONS: Among patients with chest pain, the implementation of a comprehensive communication-and-resolution program was associated with substantially reduced growth rates in the use of diagnostic testing and imaging services. Further research is needed to establish to what extent these changes were attributable to the program and clinically appropriate.Copyright Health Research and Educational Trust.DATA COLLECTION METHODS: We used discharge records submitted to a central statewide repository.DATA SOURCE: Records of patients discharged with a principal diagnosis of chest pain from 44 nonfederal general hospitals in Cook County, Illinois, between January 2002 and December 2009.OBJECTIVE: To test if a 2006 communication-and-resolution program to address unexpected adverse outcomes was associated with changes in cost and use trajectories.PRINCIPAL FINDINGS: Relative to the comparison hospitals and to pre-implementation trends, and consistent with reduced testing at presentation, the intervention hospital recorded an increase in the number of patients with a principal diagnosis of chest pain. Among admitted patients, quarterly growth rates of clinical laboratory and radiology charges at the intervention hospital declined by 3.8 and 6.9 percentage points.STUDY DESIGN: Propensity-score matched discharges from the intervention and comparison hospitals before computing difference-in-differences estimates of quarterly growth rates.All authors: Helmchen LA, Lambert BL, McDonald TBFiscal year: FY2017Digital Object Identifier:

https://dx.doi.org/10.1111/1475-6773.12610

Date added to catalog: 2017-04-11

Holdings ( 1 )
Title notes ( 9 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	27892622	Available		27892622

Available online through MWHC library: 2013 to the present, Available in print through MWHC library: 1999 - 2005

CONCLUSIONS: Among patients with chest pain, the implementation of a comprehensive communication-and-resolution program was associated with substantially reduced growth rates in the use of diagnostic testing and imaging services. Further research is needed to establish to what extent these changes were attributable to the program and clinically appropriate.

DATA COLLECTION METHODS: We used discharge records submitted to a central statewide repository.

DATA SOURCE: Records of patients discharged with a principal diagnosis of chest pain from 44 nonfederal general hospitals in Cook County, Illinois, between January 2002 and December 2009.

OBJECTIVE: To test if a 2006 communication-and-resolution program to address unexpected adverse outcomes was associated with changes in cost and use trajectories.

PRINCIPAL FINDINGS: Relative to the comparison hospitals and to pre-implementation trends, and consistent with reduced testing at presentation, the intervention hospital recorded an increase in the number of patients with a principal diagnosis of chest pain. Among admitted patients, quarterly growth rates of clinical laboratory and radiology charges at the intervention hospital declined by 3.8 and 6.9 percentage points.

STUDY DESIGN: Propensity-score matched discharges from the intervention and comparison hospitals before computing difference-in-differences estimates of quarterly growth rates.

English