Albert W. Wu, MD, MPH, senior author of the study and associate professor in the Department of Health Policy and Management at the Bloomberg School of Public Health, explained that grading physicians can be difficult for a variety of reasons. "If all physicians receive the equivalent of an 'A' on a certain indicator, that does not help distinguish between the doctors. For some indicators, it can also difficult to obtain reliable data from patients. And finally, surveying a doctor who doesn't treat enough patients won't give you an accurate picture of how the physician is performing."
The researchers analyzed surveys collected from 2,515 asthmatic patients from 20 California-based physician groups from 1998-1999. Doctors were assessed based on six quality indicators, as reported by their patients--accessibility of asthma care for patients; self management of asthma care; the use of inhaled corticosteroids; satisfaction with asthma care; improvement in health; and the number of emergency department visits and hospitalizations attributable to asthma.
The researchers found that patients were able to give reliable answers about these indicators of the care they were getting. However, they also found that having a sufficient number of patients was key to getting useful results.
"Our findings have practical implications for managed care decision makers
Contact: Kenna L. Lowe
Johns Hopkins University Bloomberg School of Public Health