Phillips Robert L, Blackburn Brenna, Peterson Lars E, Puffer James C
American Board of Family Medicine, Lexington, KY
University of Utah, Salt Lake City, UT.
Am J Med Qual. 2016 May;31(3):217-23. doi: 10.1177/1062860615571662. Epub 2015 Mar 2.
Aligning maintenance of certification with quality reporting may ease reporting burden, but the impact on quality is uncertain. This study compared changes in quality measures from American Board of Family Medicine Performance in Practice Modules (PPMs), Physician Quality Reporting System (PQRS), and a combined PQRS/PPM for diabetes between 2008 and 2012. Physicians completed 7264 diabetes PPMs, 297 only reported PQRS measures 2 or more times, and 675 completed a combination project, representing more than 200 000 patients. After adjustment, PQRS and PQRS/PPM projects were associated with greater blood pressure and cholesterol control improvement than PPM only (P < .05). PPM-only projects had greater improvement than PQRS-only projects on 4 of 6 process measures and greater hemoglobin A1c improvement (P < .05) but were only better on 2 process measures and on hemoglobin A1c control than PQRS/PPM projects. These findings identify differences between quality reporting and quality improvement, suggesting reason to align the 2 programs.
将认证维护与质量报告相结合可能会减轻报告负担，但对质量的影响尚不确定。本研究比较了2008年至2012年间美国家庭医学委员会实践绩效模块（PPM）、医师质量报告系统（PQRS）以及PQRS/PPM联合项目中糖尿病质量指标的变化。医生们完成了7264个糖尿病PPM，297人仅报告PQRS指标2次或更多次，675人完成了联合项目，涉及超过200000名患者。调整后，PQRS和PQRS/PPM项目与仅PPM相比，在血压和胆固醇控制改善方面更显著（P < 0.05）。仅PPM项目在6项过程指标中的4项上比仅PQRS项目有更大改善，糖化血红蛋白改善也更显著（P < 0.05），但在2项过程指标和糖化血红蛋白控制方面仅比PQRS/PPM项目更好。这些发现明确了质量报告和质量改进之间的差异，表明有理由将这两个项目结合起来。
