How hospitals can improve their public quality metrics: a decision-theoretic model.

摘要: The public reporting of hospitals' quality care is providing additional motivation for hospitals to deliver high-quality patient care. Hospital Compare, a consumer-oriented website by the Centers Medicare and Medicaid Services (CMS), provides patients with detailed data on most US hospitals. Given that many metrics are aggregate result physicians' individual clinical decisions, question arises if how could influence their physicians so decisions positively contribute goals. In this paper, we develop decision-theoretic model explore three different hospital interventions-incentivization, training, nudging-may affect decisions. We focus our analysis Outpatient Measure 14 (OP-14), which an imaging metric reports percentage outpatients brain computed tomography (CT) scan, who also received same-day sinus CT scan. cases, scans considered unnecessary, high utilizing aim reduce OP-14 metric. Our captures decision process accounting medical behavioral factors, in particular uncertainty assessment physician's diagnostic ability. shows interventions incentivization, nudging physician consequently OP-14. This foundation insights policy makers multi-level effects