Primary care in the United States: Profiling performance in primary care in the United States

doi:10.1136/bmj.326.7392.744

BMJ 2003;326:744-747 ( 5 April )

Primary care

Primary care in the United States

Profiling performance in primary care in the United States

Norbert Goldfield, medical director ^a, Shamini Gnani, specialist registrar ^b, Azeem Majeed, professor ^b.

^a 3M Health Information Systems, Wallingford, CT 06492, USA, ^b Primary Care Research Unit, School of Public Policy, University College London, London WC1H 9QU

Correspondence to: A Majeed a.majeed@ucl.ac.uk

The first 150 words of the full text of this article appear below.

Purchasers of health care in both the United States (governments, employers, health plans) and the United Kingdom (government)need to be able to measure the quality of services they are payingfor.¹ Moreover, public concerns about the variable qualityof health services have increased in both countries. Measuringthe performance of primary care physicians and healthcare providersis one method of meeting these challenges. ² ³ We review thedevelopment of this approach (commonly termed "profiling") inthe United States.

Summary points

Physicians' performance is increasingly being profiled in the United States to release performance data to the public and make routinely collected data available to healthcare purchasers and regulators
The United Kingdom is likely to follow suit
To justify the burden and costs of profiling, close collaboration between physicians, healthcare organisations, and other stakeholders is needed
The performance measures used in profiling need to be standardised; duplication of effort needs to be minimised; and the objectives, measures, and methods used need to be transparent
Linking of hitherto disparate data elements such as diagnoses, pharmacy data, and laboratory results will increase the sophistication and coverage of physician profiling

Profiling performance

Physician or provider profiling is an attempt to measure the performance of doctors and providers of health care by supplyinginterested parties with information on the structure, process,and outcomes of health care.⁴ Its rationale is that analysingpatterns of care will help to reduce the variation in performanceamong doctors and lead to improvements in the quality of healthcare.⁵ Two main types of profiling are used in the United States.. . . [Full text of this article]

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