McAuley R G, Paul W M, Morrison G H, Beckett R F, Goldsmith C H
College of Physicians and Surgeons of Ontario, Toronto.
CMAJ. 1990 Dec 1;143(11):1193-9.
The office practices of 918 physicians selected through stratified random sampling from the College of Physicians and Surgeons of Ontario (CPSO) registry were assessed by peers and the Peer Assessment Committee of the CPSO from 1981 to 1985. The sample comprised 662 general practitioners (GPs) and family physicians (FPs) and 256 specialists in 11 fields. Of the physicians 749 (82%) had neither deficient records nor an unsatisfactory level of patient care. Of the GPs and FPs 97 (15%) had serious deficiencies in one or both areas, as compared with 4 (2%) of the specialists (p2 less than 0.00001). The proportions of certificants of the Royal College of Physicians and Surgeons of Canada and of the College of Family Physicians of Canada (CFPC) with serious deficiencies were low (2% and 3% respectively). Three statistically significant predictors of physician performance were found among the GPs and FPs: age, CFPC membership status and type of practice. Of the 56 physicians who were reassessed 6 to 12 months later 29 (52%) had made the improvements recommended by the committee. Our findings demonstrate the need, feasibility and acceptance of a peer assessment program of office practices in Ontario.
1981年至1985年期间,安大略省医师暨外科医师学院(CPSO)登记处通过分层随机抽样选出918名医师,其门诊医疗行为由同行及CPSO同行评估委员会进行评估。样本包括662名全科医生(GPs)和家庭医生(FPs)以及11个领域的256名专科医生。在这些医师中,749名(82%)的记录无缺陷且患者护理水平令人满意。在全科医生和家庭医生中,97名(15%)在一个或两个领域存在严重缺陷,而专科医生中这一比例为4名(2%)(p2小于0.00001)。加拿大皇家内科医师暨外科医师学院和加拿大家庭医生学院(CFPC)的持证人中存在严重缺陷的比例较低(分别为2%和3%)。在全科医生和家庭医生中发现了三个对医师表现有统计学显著影响的预测因素:年龄、CFPC会员身份和执业类型。在6至12个月后接受重新评估的56名医师中,29名(52%)已按照委员会的建议做出改进。我们的研究结果表明,安大略省门诊医疗行为同行评估项目有必要、可行且能被接受。