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Evaluation & the Health Professions
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A Cost-Effective Method to Characterize Variation in Clinical Practice

Kenneth Chang

Jefferson Medical College

Sandra Sauereisen

St. Margaret Family Practice

Mark Dlutowski

J. Jon Veloski

David B. Nash

Jefferson Medical College

This study’s objective was to measure variation in physicians’ practice styles and policies. Family physicians and general internists were surveyed about evidence-based medicine in the areas of asthma, congestive heart failure, and diabetes mellitus. They were asked about clinical recommendations where standards of practice were uncertain, controversial, or changing in response to published guidelines. Also included were items dealing with managed care. Although there was wide variation in responses to 20 of 36 items, some responses were consistent with practice guidelines. Responses to several items indicated a tendency to overuse expensive tests. Overall, the results indicate that a brief, open-ended survey can assess practice variation quickly and economically, as contrasted with more expensive analyses of medical records or claims data. With proper validation such assessments can be used as baselines to guide interventions, as well as measures of the outcomes of these interventions to change practice styles.

Evaluation & the Health Professions, Vol. 22, No. 2, 184-196 (1999)
DOI: 10.1177/01632789922034257


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Home page
American Journal of Medical QualityHome page
J. Veloski, S. Tai, A. S. Evans, and D. B. Nash
Clinical Vignette-Based Surveys: A Tool for Assessing Physician Practice Variation
American Journal of Medical Quality, May 1, 2005; 20(3): 151 - 157.
[Abstract] [PDF]