Research has shown that documents can change practice mode under peer pressure
Researchers reviewed how doctors treat varicose veins and related diseases, looking for unnecessary treatments. After clinicians received personalized peer benchmark reports, they reduced the amount of intravenous thermal ablation for each patient. This simple procedure allows blood to flow normally through the veins of the legs.
The results of the study were published on JAMA Network Open, using personalized benchmarks to locate and eliminate abnormal doctors unnecessary Operation.
Although many hospitals have obtained benchmark reports on procedures and costs, these reports usually involve the average of all surgeons in the institution.
“The problem with these benchmarks is that many times when doctors look at institutional benchmarks, they are like,’Well, this is not what I am doing, so this is driven by someone else,'” Kaitlyn Hicks said. A vascular surgeon at the Johns Hopkins School of Medicine is also a co-author of the study.
Researchers have solved intravenous thermal ablation, which is becoming more and more popular throughout the country. Researchers found that doctors usually only perform these procedures on patients at most twice a year. Outliers were ablated nearly four times in one patient within a year.
The American Venous and Lymphatic Society worked with researchers in 2018 to send personalized benchmark letters to 1,558 doctors (including 90 outliers), who often performed ablations based on 2017 Medicare claims.
Medicare pays a fixed amount for the ablation of one vein and a smaller fee for other veins treated on the same day. However, if doctors separate patients’ operations by multiple days, they will get higher pay each time.
“It is more economically profitable to do this in a repetitive procedure, rather than trying to do everything at once, although it is not necessarily better for the patient,” Hicks said. “Everyone agrees that intravenous ablation is a good thing, it’s just a matter of doing it too many times.”
Most abnormal doctors greatly reduce their practice of introducing patients over multiple days. In 2019, when researchers reviewed the claims again, nearly half of them were no longer outliers. Overall, the target clinician also moderately reduced the use of ablation.
These letters are estimated to save US$6.3 million in medical insurance, and the total cost of the research is approximately US$25,000. Hicks said these results may bring greater hope to health care spending.