Trial reportJournal of general internal medicine2011
Association between quality of care and the sociodemographic composition of physicians' patient panels: a repeat cross-sectional analysis.
Trial report in Journal of general internal medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed.
- Practice context affects efforts to improve diabetes care for primary care patients: a pragmatic cluster randomized trial.Journal of general internal medicine · 2015Trial
- Differences based on patient gender in the management of hypertension: a multilevel analysis.Journal of human hypertension · 2021Article
- Refining physician quality indicators for screening mammography in older women: distinguishing appropriate use from overuse.Journal of the American Geriatrics Society · 2013Article
- Diabetes care quality is highly correlated with patient panel characteristics.Journal of the American Board of Family Medicine : JABFMArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPay-for-performance programs could worsen health disparities if providers who care for disadvantaged patients face systematic barriers to providing high-quality care. Risk adjustment that includes sociodemographic factors could mitigate the financial incentive to avoid disadvantaged patients.
objectiveTo test for associations between quality of care and the composition of a physician's patient panel.
designRepeat cross-sectional analysis
participantsNationally representative sample of US primary care physicians responding to a panel telephone survey in 2000-2001 and 2004-2005 MAIN MEASURES: Quality of primary care as measured by provision of eight recommended preventive services (diabetic monitoring [hemoglobin A1c testing, eye examinations, cholesterol testing and urine protein analysis], cancer screening [screening colonoscopy/sigmoidoscopy and mammography], and vaccinations against influenza and pneumococcus) documented in Medicare claims data and the association between quality and the sociodemographic composition of physicians' patient panels. KEY
resultsAcross eight quality measures, physicians' quality of care was not consistently associated with the composition of their patient panel either in a single year or between time periods. For example, a substantial number (seven) of the eighteen significant associations seen between sociodemographic characteristics and the delivery of preventive services in the first time period were no longer seen in the second time period. Among sociodemographic characteristics, panel Medicaid eligibility was most consistently associated with differences in the delivery of preventive services between time points; among preventive services, the delivery of influenza vaccine was most likely to demonstrate disparities in both time points.
conclusionsIn a Medicare pay-for-performance program, a better understanding of the effect of effect of patient panel composition on physicians' quality of care may be necessary before implementing routine statistical adjustment, since the association of quality and sociodemographic composition is small and inconsistent. In addition, we observed improvements between time periods among physicians with varying panel composition.
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