同儕比較回饋對醫師開立檢驗行為的影響，四個月的觀察

Effect of Peer Comparison Feedback on Test Ordering Behaviour of Physicians: A Four-Month Observation

喻小珠(Sheau-Ju Yuh) ； 趙坤郁(Kun-Yu Chao) ； 黃凱琳(Kai-Lin Hwang) ； 王世叡(Soo-Ray Wang) ； 張玉君(Yu-Jun Chang) ； 黃靜宜(Chin-Yi Huang) ； 賴淑芬(Shu-Fen Lai) ； 莊惠真(Tammy Chuang) ； 黃昭聲(Chiau-Seng Hwang)

《台灣公共衛生雜誌》 21卷2期 (2002/04) Pp. 107-114

https://doi.org/10.6288/TJPH2002-21-02-03

摘要

Objectives: To test the hypothesis that it may be possible to reduce the number of tests and laboratory expenditure by periodic peer comparison paper feedback to physicians on statistic data of the number of tests which they prescribed. Methods: A prospective controlled trial was conducted at the outpatient clinics of Changhua Christian Hospital. Physicians from two different departments were selected as intervention group and control group to avoid contamination between groups. Among all the departments in this hospital, patients in the Department of Internal Medicine and the Department of Family Medicine have the most similar disease patterns. Five sex-, age-, and years of practice-matched physicians from each of the two departments were selected. Physicians from the Department of Family Medicine received monthly feedback from January through April in 1999 on their own statistic data of the number of tests per prescription of the preceding month. Physicians from the Department of Internal Medicine received no intervention. Prescriptions of these 10 physicians from January through April in 1998 were used as baseline data. Results: Number of prescriptions during the intervention period was 11,730 for feedback group and 7,263 for control group. During the study period, mean number of tests per prescription decreased in the feedback group (P＜0.0l) and increased in the control group (P＜0.0l)Laboratory expenditure decreased in the feedback group (P＜0.00l), but had no significant change in the control group (P=0.11), Conclusions: Periodic peer comparison paper feedback to physicians on statistic data of the number of tests they prescribed can effectively reduce the number of tests and laboratory expenditure.(Taiwan J Public Health. 2002;21(2):107-114)

關鍵字

介入性研究 ； 同儕比較 ； 回饋 ； 檢驗量 ； 檢驗支出

並列摘要

Objectives: To test the hypothesis that it may be possible to reduce the number of tests and laboratory expenditure by periodic peer comparison paper feedback to physicians on statistic data of the number of tests which they prescribed. Methods: A prospective controlled trial was conducted at the outpatient clinics of Changhua Christian Hospital. Physicians from two different departments were selected as intervention group and control group to avoid contamination between groups. Among all the departments in this hospital, patients in the Department of Internal Medicine and the Department of Family Medicine have the most similar disease patterns. Five sex-, age-, and years of practice-matched physicians from each of the two departments were selected. Physicians from the Department of Family Medicine received monthly feedback from January through April in 1999 on their own statistic data of the number of tests per prescription of the preceding month. Physicians from the Department of Internal Medicine received no intervention. Prescriptions of these 10 physicians from January through April in 1998 were used as baseline data. Results: Number of prescriptions during the intervention period was 11,730 for feedback group and 7,263 for control group. During the study period, mean number of tests per prescription decreased in the feedback group (P＜0.0l) and increased in the control group (P＜0.0l)Laboratory expenditure decreased in the feedback group (P＜0.00l), but had no significant change in the control group (P=0.11), Conclusions: Periodic peer comparison paper feedback to physicians on statistic data of the number of tests they prescribed can effectively reduce the number of tests and laboratory expenditure.(Taiwan J Public Health. 2002;21(2):107-114)

並列關鍵字

intervention study ； peer comparison ； feedback ； number of tests ； laboratory expenditure

參考文獻

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