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  Vol. 4 No. 2, February 1995 TABLE OF CONTENTS
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Improving Physicians' Preventive Health Care Behavior Through Peer Review and Financial Incentives

Robert W. Morrow, MD; Anne D. Gooding, MS; Colleen Clark, MPH

Arch Fam Med. 1995;4(2):165-169.


Abstract

We assessed improvement of preventive health care behaviors by physicians in an independent practice association—health maintenance organization. A beforeafter, 3-year study of a defined cohort measured changes through chart audit, accompanied by peer review, feedback, and financial incentives. Outcome measures consisted of rates of mump-measles-rubella (MMR) immunization, screening for cholesterol levels, and charting adequacy. Offices meeting MMR vaccination standards over 3 years increased from 78% to 96% (P<.05); those meeting standards for screening for cholesterol levels, from 92% to 95%. The average scores for charting adequacy rose from 87% to 92% (P<.05). The percentage of practices not in compliance with a standard of 90% decreased as follows: for MMR vaccination, from 57% to 12%; for screening for cholesterol levels, from 21% to 11%; and for charting adequacy, from 53% to 29% (P<.05).



Author Affiliations

From the Department of Family Medicine, St Josephs Medical Center, Yonkers, NY (Dr Morrow); the Department of Family Medicine, Montefiore Medical Center, Bronx, NY (Ms Gooding); and the Harvard Institute for Reproductive and Child Health, Boston, Mass (Ms Clark). None of the authors are employees of the independent practice association—health maintenance organization discussed herein.



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