Peer review organizations. Promises and potential pitfalls.

摘要: Abstract The Health Care Financing Administration has contracted with 54 peer review organizations (PROs) to monitor hospital use and quality of care for Medicare patients. PROs promised reductions in readmissions, "unnecessary" admissions or invasive procedures, "avoidable" mortality morbidity. A contract summaries 49 revealed wide variations reduction targets. In attempting meet their goals, will encounter numerous potential pitfalls, including inaccurate incomplete discharge data, inadequate descriptors the variety patients physicians' management plans, honest differences judgments about patient care, limited research on criteria used set targets as well means accomplish them. Despite having more explicit quality-of-care objectives, PROs, like PSROs (professional standards organizations) before them, are likely be seen agents cost containment than assurance. Both cred...