Managed care and medical practice guidelines: The thorny problem of attaining physician compliance

Advances in Health Care Management

Volumn 2, Issue , 2001, Pages 93-130

  Smith, Howard L ^a   Yourstone, Steven ^a   Lorber, David ^a   Mann, Bruce ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

EID: 0012286967     PISSN: 14748231     EISSN: None     Source Type: Book Series    
DOI: 10.1016/s1474-8231(01)02024-9     Document Type: Article

References (105)

1. C.E. Adams M. Wilson Enhanced quality through outcome-focused standardized care plans JONA 25 9 1995 27 34
2. L.H. Aiken J. Sochalski E.T. Lake Studying outcomes of organizational change in health services Medical Care 35 11 1997 NS6 NS18 Supplement
3. A. Barratt L. Irwig P. Glasziou R.G. Cumming A. Raffle N. Hicks J.A.M. Grey G. Guyatt User's guides to the medical literature JAMA 281 21 1999 2029 2034
4. M.F. Barton J.G. Elmore S.W. Fletcher Breast symptoms among women enrolled in a health maintenance organization: Frequency, evaluation, and outcome American College of Physicians-American Society of Internal Medicine 130 8 1999 651 657
5. D.W. Bates D.L. Boyle E. Rittenberg G.J. Kuperman N. Ma'Luf V. Menkin J.W. Winkelman M.J. Tanasijevicm What proportion of common diagnostic tests appear redundant? American Journal of Medicine 104 1998 361 368
6. K.M. Bell Physician profiling: 12 critical points Journal Ambulatory Care Management 19 1 1996 81 85
7. A.B. Bindman Can physician profiles be trusted? JAMA 281 22 1999 2142 2143
8. R.H. Brook Toward assessing outcomes of emergency care Academic Emergency Medicine 5 3 1998 268 269
9. W.S. Browner Diagnostic dilemma American Journal of Medicine 104 1998 406 407
10. L.R. Burns S.E. Geller D.R. Wholey The effect of physician factors on the cesarean section decision Medical Care 33 4 1995 365 382
11. L.C. Burton P.S. German S. Shapiro The Johns Hopkins Medicare preventive services demonstration team Medical Care 35 11 1997 1149 1157
12. T.S. Carey J. Garrett A. Jackman C. McLaughlin J. Fryer D.R. Smucker The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors and orthopedic surgeons The New England Journal of Medicine 333 14 1995 913 917
13. B. Carmine Update and evaluation of Australian guidelines: Industry perspective Medical Care 34 12 1996 DS226 DS232
14. J.A. Chatman Improving interactional organizational research: A model of person-organization fit Academy of Management Review 14 3 1989 333 349
15. Chatman, J.A., & Barsade, S.G. Personality, organizational culture, and cooperation. Administrative Science Quarterly , 40(2), 423–444.
16. P.M. Colegrove H.N. Winfield J.F. Donovan Jr. W.A. See Laparoscopic practice patterns among North American urologists 5 years formal training The Journal of Urology 161 1999 881 886
17. D.J. Cook N.L. Greengold A.G. Ellrodt S.R. Weingarten The relation between systematic reviews and practice guidelines Annals of Internal Medicine 127 3 1997 210 216
18. T.W. Croghan B.M. Johnstone D.P. Buesching R.C. Kessler Information needs for medication coverage decisions in a state medicaid program Medical Care 37 4 1999 AS24 AS31
19. R. Czaja S.L. McFall R.B. Warnecke L.J. Ford A.D. Kaluzny Preferences of community physicians for cancer screening guidelines Annals of Internal Medicine 120 7 1994 602 608
20. P.L. Davis Practice Guidelines 101 MGM Journal, September/October 1996 9 10
21. P.A. Ebert The importance of data in improving practice: Effective clinical use of outcomes data Ann Thorac Surg 58 1994 1812 1814
22. A.G. Ellrodt L. Conner M. Riedinger S. Weingarten Measuring and improving physician compliance with clinical practice guidelines Annals of Internal Medicine 122 4 1995 277 282
23. G. Ellrodt D.J. Cook J. Lee M. Cho D. Hunt S. Weingarten Evidence-based disease management JAMA 278 20 1997 1687 1692
24. A. Epstein Sounding board: Performance reports on quality - prototypes, problems, and prospects The New England Journal of Medicine 333 1 1995 57 61
25. V.L. Ernster Mammography screening for women aged 40–49. A guidelines saga and a clarion call for informed decision making American Journal of Public Health 87 7 1997 1103 1106
26. J.J. Escarce H.I. Feldman Cost functions for dialysis facilities and the quality of dialysis Health Services Research, February 1999 33 6 1999 1564 1566
27. R.H. Falk Adverse reactions to medication on a coronary care unit Postgrad. Medical Journal 55 1979 870
28. E. Fang B.S. Mittman S. Weingarten Use of clinical practice guidelines in managed care physician groups Arch. Fam. Med. 5 1996 528 531
29. G. Feder M. Eccles R. Grol C. Griffiths J. Grimshaw Using clinical guidelines BMJ 318 1999 728 730
30. D. Feldman Gatekeeping: Good or bad, but never indifferent JAMA 279 12 1998 908
31. M.J. Field K.N. Lohr Clinical practice guidelines: Directions for a new program 1990 National Academy Press Washington, DC
32. H.V. Fineberg D. Scadden L. Goldman Care of patients with a low probability of acute myocardial infarction: Cost effectiveness of alternatives to coronary-care-unit admission New England Journal of Medicine 310 1984 1301 1307
33. A. Frances D. Kahn D. Carpenter C. Frances J. Docherty A new method of developing expert consensus practice guidelines The American Journal of Managed Care 4 7 1998 1023 1029
34. P. Franks J. Zwanziger C. Mooney M. Sorbero Variations in primary care physician referral rates Health Services Research 34 1 1999 323 329
35. R.S. Galvin Are performance measures relevant? Health Affairs 17 4 1998 29 31
36. L.J. Goebel A peer review feedback method of promoting compliance with preventive care guide lines in a resident ambulatory care clinic Journal on Quality Improvement 23 4 1997 196 202
37. M.R. Gold R. Hurley T. Lake T. Ensor R. Berenson A national survey of the arrangements managed-care plans make with physicians New England Journal of Medicine 333 25 1995 1678 1683
38. C. Gregory M. Cifaldi L.A. Tanner Targeted intervention programs: Creating a customized practice model to improve the treatment of allergic rhinitis in a managed care population The American Journal of Managed Care 5 4 1999 485 496
39. B.R. Greene J. Barlow C. Newman Ambulatory care groups and the profiling of primary care physician resource use: Examining the application of case mix adjustments Journal of Ambulatory Care Management 19 1 1996 86 89
40. J.M. Grimshaw I.T. Russell Effect of clinical guidelines on medical practice: A systematic review of rigorous evaluations The Lancet 342 1993 1317 1322
41. E.A. Halm N. Causino D. Blumenthal Is gatekeeping better than traditional care? JAMA 278 20 1997 1677 1681
42. J.L. Hargraves R.H. Palmer E.J. Orav E.A. Wright Are differences in practitioner's acceptance of a quality assurance intervention related to their performance? Medical Care 34 9 1996 SS77 SS86
43. J.M. Harris Jr. Papanicolaou smear recommendations, patient complaints, and patient satisfaction in managed-care medical organizations Medical Care 33 3 1995 272 279
44. D.S. Havens L.H. Aiken Shaping systems to promote desired outcomes JONA 29 2 1999 14 20
45. Haycox, A. Bagust, A., & Walley, T. Education and debate: Clinical guidelines-the hidden costs. BMJ , 318, 391–393.
46. Hayward, R. S. A., Wilson, M. C., Tunis, S. R., Bass, E. B., & Guyatt, G (????). User's guides to the medical literature. JAMA , 274(7), 570–574.
47. D. Heacock R.A. Brobst A multidisciplinary approach to critical path development: A valuable CQI tool Journal of Nursing Care Quality 8 4 1994 38 41
48. Hendryx, M. S., Dyck, D. G., & Srebnik, D. (????). Risk-adjusted outcome models for public mental health out patient programs. Health Services Research , 34(1), 171–195.
49. M.S. Hendryx D.S. Wakefield J.F. Murray T. Uden-Holman C.M. Helms R.L. Ludke Using comparative clinical and economic outcome information to profile physician performance Health Services Management Research 8 4 1995 213 219
50. B.J. Hillman C.A. Joseph M.R. Mabry J.H. Sunshine S.D. Kennedy M. Noether Frequency and costs of diagnostic imaging in office practice — a comparison of self-referring and radiologist-referring physicians New England Journal of Medicine 323 1990 1604 1608
51. Hillman, A. L., Pauly, M. V., Kerman, K., & Martinek, C. R. (????). HMO managers' views on financial incentives and quality. Health Aff. (Millwood) , 10(4), 207–219.
52. R.A. Hirth P.J. Held S.M. Orzol A. Dor Practice patterns, case mix, Medicare payment policy, and dialysis facility costs Health Services Research 33 6 1999 1567 1592
53. T.P. Hofer R.A. Hayward S.S. Greenfield E.H. Wagner S.H. Kaplan W.G. Manning The unreliability of individual physician “report cards” for assessing the costs and quality of care of a chronic disease JAMA 281 22 1999 1099 2105
54. How evidence-based medicine will change the way you practice. (Roundtable) Medical Economics, March 1999 120 133
55. A.L. Hyams D.W. Shapiro T.A. Brennan Medical practice guidelines in malpractice litigation: An early retrospective Journal of Health Politics, Policy and Law 21 2 1996 289 313
56. Institute of Medicine Guidelines for clinical practice: From development to use 1992 National Academy Press Washington, DC
57. K.A. Jehn J.C. Chatman The influence of proportional and perceptual conflict composition on team performance International Journal of Conflict Management 11 1 2000 56 73
58. D.A. Katz Barriers between guidelines and improved patient care: An analysis of AHCPR's unstable angina clinical practice guideline Health Services Research 34 1 1999 377 389
59. S.D. Keller T.C. Majkut M. Kosinski J. Ware Jr. Monitoring health outcomes among patients with arthritis using the SF-36 health survey Medical Care 37 5, Suppl. 1999 MS1 MS9
60. H.C. Kelman Process of opinion change Public Opinion Quarterly 1961 57 78 (Spring)
61. M.H. Keslin C.M. Jarrell C. Gregory Diagnosis and treatment of allergic rhinitis: Primary care in an integrated health system setting The American Journal of Managed Care 5 4 1999 S249 S256
62. C.N. Klabunde M.A. O'Malley A.D. Kaluzny Physicians' reactions to change in recommendations for mammography screening American Journal of Preventive Medicine 13 6 1997 432 438
63. R.H. Lagoe D.L. Aspling Enlisting physician support for practice guidelines in hospitals Health Care Management Review 21 4 1996 61 67
64. L.L. Leape Translating medical science into medical practice: Do we need a national medical standards board? JAMA 273 19 1995 1534 1537
65. B.E. Lewis HMO outcomes research: Lessons from the field Journal of Ambulatory Care Management 18 1 1995 47 55
66. L.K. Lichtig R.A. Knauf D.K. Milholland Some impacts of nursing on acute care hospital outcomes JONA 29 2 1999 25 33
67. D.F. Lobach W.E. Hammond Computerized decision support based on a clinical practice guideline improves compliance with care standards American Journal of Medicine 102 1997 89 98
68. J. Lomas G.M. Anderson K. Domnick-Pierre E.E. Vayda M.W. Enkin W.J. Hannah Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians New England Journal of Medicine 321 19 1989 1306 1311
69. E.R. McFadden Jr. N. Elsanadi L. Dixon M. Takacs E.C. Deal K.K. Boyd B.K. Idemoto L.A. Broseman J. Panuska T. Hammons B. Smith F. Caruso C.B. McFadden L. Shoemaker E.L. Warren R. Hejal L. Strauss I.A. Gilbert Protocol therapy for acute asthma: Therapeutic benefits and cost savings American Journal of Medicine 99 1995 651 661
70. S.L. McFall R.B. Warnecke A.D. Kaluzny L. Ford Practice setting and physician influences on judgements of colon cancer treatment by community physicians Health Services Research, April 31 1 1996 5 19
71. J. Melnikow J. Nuovo M. Paliescheskey Management choices for patients with “squamous atypia” on Papanicolaou smear Medical Care 34 4 1996 336 347
72. P.J. O'Connor E.S. Quiter W.A. Rush M. Wiest J.T. Meland S. Ryu Impact of hypertension guideline implementation on blood pressure control and drug use in primary care clinics Journal on Quality Improvement 25 2 1999 68 77
73. C.A. O'Reilly III J.A. Chatman D.F. Caldwell People and organizational culture: A profile comparison approach to assessing person-organization fit Academy of Management Journal 34 3 1991 487 516
74. B.G. Ortmeier Conducting clinical and health economic outcome studies in an ambulatory setting Journal of Ambulatory Care Management 20 4 1996 10 16
75. R.C. Paniello K.S. Virgo M.H. Johnson M.F. Clemente F.E. Johnson Practice patterns and clinical guidelines for post-treatment follow-up of head and neck cancers Arch. Otolaryngol Head Neck Surgery 125 1999 309 313
76. A.L. Potosky R.M. Merrill G.F. Riley S.H. Taplin W. Barlow B.H. Fireman J.D. Lubitz Prostate cancer treatment and ten-year survival among group/staff HMO and fee-for-service medicare patients Health Services Research 34 2 1999 525 546
77. M.W. Pozen R.B. D'Agostino J.B. Mitchell D.M. Rosenfeld J.T. Guglielmino M.L. Schwartz N. Teebagy J.M. Valentine J.M. Hood Jr. The usefulness of a predictive instrument to reduce inappropriate admissions to the coronary care unit Annals of Internal Medicine 92 1980 238 242
78. P.J. Pronovost M.W. Jenckes T. Dorman E. Garrett M.J. Breslow B.A. Rosenfeld P.A. Lipsett E. Bass Organizational characteristics of intensive care units related to outcomes of abdominal aortic surgery JAMA 281 14 1999 1310 1317
79. D.M. Radosevich A framework for selecting outcome measures for ambulatory care research Journal of Ambulatory Care Management 20 4 1997 1 9
80. A.G. Randolph Reorganizing the delivery of intensive care may improve patient outcomes JAMA 281 14 1999 1330 1331
81. M.C. Reid D.A. Lane A.R. Feinstein Academic calculations versus clinical judgements: Practicing physicians' use of quantitative measures of test accuracy The American Journal of Medicine 104 1998 374 380
82. W.A. Reinke Quality management in managed care Health Care Management: State of the Art Reviews 2 1 1995 79 89
83. R. Santos M. Cifaldi C. Gregory P. Seitz Economic outcomes of a targeted intervention program: The costs of treating allergic rhinitis patients The American Journal of Managed Care 5 4 1999 S225 S233
84. R.S. Scott New standards and the practice of radiology: Where the art of medicine is lost Administrative Radiology 14 5 1995 41 42
85. C. Sennett Moving ahead, measure by measure Health Affairs 17 4 1998 36 37
86. H.L. Smith N.F. Piland R. Discenza Strategies for managing free agents in organizational cultures Journal of Managerial Issues 2 3 1990 307 324
87. W.B. Stason Can clinical practice guidelines increase the cost-effectiveness of geriatric rehabilitation? Medical Care 35 6 1997 JS68 JS77
88. D.M. Steinwachs A.W. Wu E.A. Skinner How will outcomes management work? Health Affairs 1994 153 162
89. D.H. Sykes A.E. Evans D.M. Boyle E.L. McIlmoyle K.S. Salathia Discharge from a coronary care unit: Psychological factors J. Psychom. Res. 33 1989 477 488
90. S.O. Thier A.C. Gelljns Improving health: The reason performance measurement matters Health Affairs 17 4 1998 26 28
91. W.M. Tierney S.L. Hui C.J. McDonald Delayed feedback of physician performance versus immediate reminders to perform preventive care Medical Care 24 8 1986 659 666
92. A.S. Tsui T.D. Egan C.A. O'Reilly III Being different: Relational demography and organizational attachment Administrative Science Quarterly 37 4 1992 549 580
93. A.M. Tucker J.P. Weiner S. Honigfeld R.A. Parton Profiling primary care physician resource use: Examining the application of case mix adjustment Journal of Ambulatory Care Management 19 1 1996 60 80
94. E. Volpintesta Gatekeeping: Good or bad, but never indifferent JAMA 279 12 1998 909
95. J.H. Ware Jr. M. Kosinski M.S. Bayliss C.A. McHorney W.H. Rogers A. Raczek Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: Summary of results from the medical outcomes study Medical Care 33 4 1995 AS264 AS279
96. J.P. Weiner S.T. Parente D.W. Garnick J. Fowles A.G. Lawthers H. Palmer Variation in office-based quality: A claims-based profile of care provided to Medicare patients with diabetes JAMA 273 19 1995 1503 1508
97. S. Weingarten L. Agocs N. Tankel A. Shent A.G. Ellrodt Reducing lengths of stay for patients hospitalized with chest pain using medical practice guidelines and opinion leaders The American Journal of Cardiology 71 4 1993 259 262
98. S.R. Weingarten M.S. Riedinger L. Conner T.H. Lee I. Hoffman B. Johnson A.G. Ellrodt Practice guidelines and reminders to reduce duration of hospital stay for patients with chest pain Annals of Internal Medicine 120 4 1994 257 263
99. C.A. Wells Jr. Managed care strategies for rural providers Health Care Financial Management 1996 37 39
100. J. Wennberg Why treatment varies so greatly Medical Economics 1997 40 56
101. J. Whittle J.L. Chyonghiou J.R. Lave M.J. Fine K.M. Delaney D.Z. Joyce W.W. Young W.N. Kapoor Relationship of provider characteristics to outcomes, process, and costs of care for community-acquired pneumonia Medical Care 36 7 1998 977 987
102. M.C. Wilson R.S.A. Hayward S.R. Tunis E.B. Bass G. Guyant Users' guides to the medical literature JAMA 274 20 1995 1630 1632
103. S.H. Wolf R. Grol A. Hutchinson M. Eccles J. Grimshaw Potential benefits limitations, and harms of clinical guidelines BMJ 318 1999 527 530
104. S. Woolhandler D.U. Himmelstein Extreme risk - the new corporate proposition for physicians New England Journal of Medicine 333 25 1995 1706 1708
105. B.P. Yawn M. Casey P. Hebert The rural health care workforce implications of practice guideline implementation Medical Care 37 3 1999 259 269