Performance measurement in the small office practice: challenges and potential solutions.

摘要: Great strides have been made in the creation of programs aimed at improving safety and quality health care United States, including measurement systems corresponding standards ambulatory setting that are used for public reporting or pay-for-performance. The diversity physician practices States makes challenging. In many parts country, substantial proportions both primary specialist physicians continue to practice solo small group practices. This article reviews landscape States; describes performance challenges settings, financial staffing implications; discusses statistical issues affect assessment quality; potential solutions raised. Challenges settings include lack infrastructure information technology, support staff, increased burden. These compounded by difficulty assessing a smaller number patients spread over multiple payers. To overcome some these challenges, design measure selection recommendations system presented practice-level plan-level interventions suggested might facilitate inclusion programs. Because high proportion U.S. policies based on should incorporate features physicians.