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Pediatric Preventive Care Incentives in a Medicaid HMO. Abstract, ExecutiveSummary and Final Report

机译：医疗补助HmO中的儿科预防护理激励措施。摘要，执行摘要和最终报告

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摘要

This randomized controlled trial assessed the impact of feedback and financialincentives on physician compliance with pediatric preventive care guidelines in a Medicaid managed care organization. Fifty-three primary care sites were assigned to one of three study groups: (1) feedback reports and financial incentives, (2) feedback reports only, or (3) control (no feedback or financial incentive). Compliance with guidelines for immunizations and other preventive services was evaluated through semi-annual chart audits in 1994-1995. Overall, compliance scores increased from 53.6% at baseline to 71% at Audit 4. We observed significant increases over time in all groups (p<.001), but no differences among groups. Multivariate analyses revealed that group practices had higher immunization scores than solo practices and pediatricians had high overall scores than other practitioners (p<0.05). This intervention did not improve physician compliance with screening guidelines during the study. Possible explanations include: the financial incentive was not great enough, or the study was not long enough; a secular improvement in pediatric preventive care 'drowed out' the effects of the intervention during the study period; patient-mediated factors (not targeted in this study) were essential to improving pediatric preventive care.

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