Improving physicians' preventive health care behavior through peer review and financial incentives

Morrow, Robert; Gooding, Anne D.; Clark, Colleen

doi:10.1001/archfami.4.2.165

Cited by 62 publications

(30 citation statements)

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“…Adherence also requires skill and support from the policies, peers, and supervisors of the organization in which practice occurs. A vast experimental literature 8,[22][23][24][25][26][27] also supported the model, and our extensive interviews with participants, their supervisors, and National Immunization Program personnel provided convergent validation of the model and the findings.…”

Section: Theoretical Frameworkmentioning

confidence: 67%

Effects of traditional classroom and distance continuing education: a theory-driven evaluation of a vaccine-preventable diseases course

Umble

Cervero²,

Yang³

et al. 2000

Am J Public Health

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OBJECTIVES: This study evaluated the effects of a major federal immunization continuing education course, delivered in both traditional classroom and satellite broadcast versions, on public health professionals' knowledge, agreement, self-efficacy, and adherence in practice to recommendations. METHODS: The study used a comparative time series design to determine whether the course influenced participants' knowledge, agreement, self-efficacy, and adherence in practice to general and polio-specific recommendations as measured immediately and 3 months after the course. It also compared the effects of the classroom and satellite broadcast versions and used path analysis to show how the outcomes were related to one another. RESULTS: Both versions significantly improved knowledge, agreement, self-efficacy, and adherence. Knowledge and agreement were significant predictors of self-efficacy, which directly predicted adherence. Vaccine availability and supportive clinic policies were also important adherence predictors. CONCLUSIONS: A well-designed training update can change provider knowledge, agreement, self-efficacy, and adherence. Traditional classroom and distance training can have comparable effects. The findings support incorporation of distance learning in national public health training, if the distance learning is used wisely in relation to training needs, goals, and practice contexts.

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Section: Theoretical Frameworkmentioning

confidence: 67%

Effects of traditional classroom and distance continuing education: a theory-driven evaluation of a vaccine-preventable diseases course

Umble

Cervero²,

Yang³

et al. 2000

Am J Public Health

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“…[20][21][22][23][24][25][26][27][28] Some contend that managed care's emphasis on preventive and primary care [29][30][31] has led to more cost-effective clinical practice. Others have raised concerns that managed care incentives and rules place physicians in a position with potentially conflicting obligations to patients and insurers.…”

Section: Discussionmentioning

confidence: 99%

Patients’ trust in their physicians

et al. 1998

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OBJECTIVE:To evaluate the extent to which physician choice, length of patient-physician relationship, and perceived physician payment method predict patients' trust in their physician. DESIGN:Survey of patients of physicians in Atlanta, Georgia. PATIENTS:Subjects were 292 patients aged 18 years and older. MEASUREMENTS AND MAIN RESULTS:Scale of patients' trust in their physician was the main outcome measure. Most patients completely trusted their physicians "to put their needs above all other considerations" (69%). Patients who reported having enough choice of physician ( p Ͻ .05), a longer relationship with the physician ( p Ͻ .001), and who trusted their managed care organization ( p Ͻ .001) were more likely to trust their physician. Approximately two thirds of all respondents did not know the method by which their physician was paid. The majority of patients believed paying a physician each time a test is done rather than a fixed monthly amount would not affect their care (72.4%). However, 40.5% of all respondents believed paying a physician more for ordering fewer than the average number of tests would make their care worse. Of these patients, 53.3% would accept higher copayments to obtain necessary medical tests. T rust is a fundamental aspect of the patient-physician relationship. 1-5 Even well-informed and knowledgeable patients have to rely on their physicians to provide them with appropriate information, keep personal information confidential, provide competent care, and act in their best interests. In spite of the importance of trust to the patient-physician relationship, there are few studies of the factors related to patients' trust in their physicians. CONCLUSIONS:One predictor of trust in social relationships is the length of those relationships, 6-8 and there is reason to believe this would hold for patient-physician relationships. 9 Having a choice of physician is important to many patients, 10-13 and it is possible that wider choices would encourage greater trust in the physician eventually chosen. Recent developments in health care delivery also make it plausible that the way physicians are paid could influence patients' trust in them. Reports regularly appear in the popular press about how new managed care arrangements may compromise the care provided to patients. Health service researchers have shown that payment methods may have an impact on clinical decision making. 14-16 We know of no empirical studies that have examined whether patients' beliefs about how their physician is paid affect their trust in the physician. In the study described herein, we interviewed a probability sample of patients covered by a large health care insurer in Atlanta. We assessed how patients thought their physicians were paid and whether their perceptions were accurate. We also examined whether availability of a choice of physicians, length of patient-physician relationship, or perceived physician payment method was related to the patients' trust in their physician. METHODS Study Design and SampleThe study was con...

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“…86,94,146,239 Thirteen studies were not included in the review because of limited execution. 69,81,139,194,211,213,218,220,[231][232][233]237,238 Details regarding the 14 qualifying studies are provided at the website: http://web.health.gov/communityguide. Qualifying studies presented data regarding seven intervention arms evaluating assessment and feedback only and nine intervention arms evaluating assessment and feedback used as a part of a multicomponent intervention.…”

Section: Assessment and Feedback For Vaccination Providersmentioning

confidence: 99%

Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults11The names and affiliations of the Task Force members are listed on page v of this supplement and at http://www.thecommunityguide.org22Some of this material was published previously in: Shefer A, Briss P, Rodewald L, et al. Improving immunization coverage rates: an evidence-based review of the literature. Epidemiol Rev 1999;20:96–142.

Briss

Rodewald

Hinman

et al. 2000

American Journal of Preventive Medicine

467

103

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Background: This paper presents the results of systematic reviews of the effectiveness, applicability, other effects, economic impact, and barriers to use of selected population-based interventions intended to improve vaccination coverage. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis for recommendations by the Task Force on Community Preventive Services (the Task Force) regarding the use of these selected interventions. The Task Force recommendations are presented on pp. 92-96 of this issue. Medical Subject Headings (MeSH):vaccine-preventable diseases, vaccination coverage, community health services, decision-making, evidence-based medicine, systematic reviews, population-based interventions, practice guidelines, preventive health services, public health practice, task force. Introduction V accine-preventable diseases among children, adolescents, and adults represent major continuing causes of morbidity and mortality in the United States. During the latter half of the twentieth century, the success of childhood vaccination programs in the United States has led to a Ͼ95 % decline in most vaccine-preventable diseases of childhood. However, Ͼ400,000 cases of illness and Ͼ30,000 deaths caused by vaccine-preventable diseases still occur each year 1 (CDC unpublished data).Diphtheria, invasive Haemophilus influenzae type b (Hib) disease, measles, poliomyelitis, rubella, tetanus, mumps, varicella, and pertussis are typically referred to as vaccine-preventable diseases of childhood. Vaccinations primarily indicated for adults include influenza, pneumococcal, and hepatitis B. However, during the 1990s, the distinction between childhood and adult vaccine-preventable diseases became less clear. Many childhood vaccine-preventable infections, including measles and pertussis, are found increasingly among adults, 2,3 and hepatitis B vaccinations are now routinely recommended for infants and adolescents. Table 1 outlines universally recommended (i.e., vaccinations recommended for most or all persons in certain age groups) vaccinations for children, adolescents, and older adults.In children, Ͼ50,000 cases of varicella occur each year, making that disease the most common vaccinepreventable disease among children 4 ; in adults, influenza, pneumococcal disease, and hepatitis B are all still common vaccine-preventable diseases, with hundreds of thousands of cases occurring each year.5 Mortality attributable to vaccine-preventable diseases is still substantial. Each year, approximately 500 persons in the United States die of childhood vaccine-preventable diseases, and Ͼ30,000 adults die of influenza, pneumococcal infections, and hepatitis B.1 Influenza, which accounts for an average of 20,000 deaths/year, is usually the largest killer. 5The effectiveness of universally recommended vaccinations in preventing disease for adults, adolescents, and children is well-established. 6 -14 In addition to protecting individuals from diseases passed from person to person contact, vaccinat...

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Improving physicians' preventive health care behavior through peer review and financial incentives

Cited by 62 publications

References 0 publications

Effects of traditional classroom and distance continuing education: a theory-driven evaluation of a vaccine-preventable diseases course

Effects of traditional classroom and distance continuing education: a theory-driven evaluation of a vaccine-preventable diseases course

Patients’ trust in their physicians

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