Segal H E, Rummel L, Wu B
Keystone Peer Review Organization, Inc, Harrisburg, PA.
QRB Qual Rev Bull. 1993 May;19(5):152-7. doi: 10.1016/s0097-5990(16)30610-8.
As part of a small-area analysis of carotid endarterectomy (CE) surgery, this review of Medicare claims data for a 26-month period addresses variations in surgical volume, mortality, readmissions, and charges. A surprisingly high percentage of surgeons performing CE did few procedures, and surgical volume appeared to be associated with higher mortality and charges. The implications of these data for both hospital credentialing committees and management and for purchasers and consumers of care, as well as the ways in which the Health Care Financing Organization's (HCFA) Health Care Quality Improvement Initiative (HCQII) will reorder their relationships with peer review organizations (PROs), are discussed. This study is useful in addressing the potential of efforts by PROs to increase the quality of care under the HCQII.
作为颈动脉内膜切除术（CE）手术小区域分析的一部分，本次对医疗保险索赔数据进行的为期26个月的审查探讨了手术量、死亡率、再入院率和费用方面的差异。实施CE手术的外科医生中，进行手术极少的比例高得出奇，而且手术量似乎与较高的死亡率和费用相关。文中讨论了这些数据对医院资格审查委员会、管理层以及医疗服务购买者和消费者的影响，以及医疗保健融资组织（HCFA）的医疗保健质量改进计划（HCQII）将如何重新调整其与同行评审组织（PRO）关系的方式。本研究有助于探讨PRO在HCQII下提高医疗质量方面所做努力的潜力。
