ERIC Number: EJ1036169
Record Type: Journal
Publication Date: 2013-Dec
Abstractor: As Provided
Physician Performance Assessment: Prevention of Cardiovascular Disease
Lipner, Rebecca S.; Weng, Weifeng; Caverzagie, Kelly J.; Hess, Brian J.
Advances in Health Sciences Education, v18 n5 p1029-1045 Dec 2013
Given the rising burden of healthcare costs, both patients and healthcare purchasers are interested in discerning which physicians deliver quality care. We proposed a methodology to assess physician clinical performance in preventive cardiology care, and determined a benchmark for minimally acceptable performance. We used data on eight evidence-based clinical measures from 811 physicians that completed the American Board of Internal Medicine's Preventive Cardiology Practice Improvement Module[Superscript SM] to form an overall composite score for preventive cardiology care. An expert panel of nine internists/cardiologists skilled in preventive care for cardiovascular disease used an adaptation of the Angoff standard-setting method and the Dunn-Rankin method to create the composite and establish a standard. Physician characteristics were used to examine the validity of the inferences made from the composite scores. The mean composite score was 73.88 % (SD = 11.88 %). Reliability of the composite was high at 0.87. Specialized cardiologists had significantly lower composite scores (P = 0.04), while physicians who reported spending more time in primary, longitudinal, and preventive consultative care had significantly higher scores (P = 0.01), providing some evidence of score validity. The panel established a standard of 47.38 % on the composite measure with high classification accuracy (0.98). Only 2.7 % of the physicians performed below the standard for minimally acceptable preventive cardiovascular disease care. Of those, 64 % (N = 14) were not general cardiologists. Our study presents a psychometrically defensible methodology for assessing physician performance in preventive cardiology while also providing relative feedback with the hope of heightening physician awareness about deficits and improving patient care.
Descriptors: Physicians, Medical Services, Evaluation Methods, Performance Based Assessment, Heart Disorders, Prevention, Standard Setting, Scores, Inferences, Benchmarking, Preventive Medicine, Feedback (Response)
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Authoring Institution: N/A