Schneiter E J, Keller R B, Wennberg D
Maine Medical Assessment Foundation, Manchester 04351-0249, USA.
Jt Comm J Qual Improv. 1998 Oct;24(10):579-84. doi: 10.1016/s1070-3241(16)30405-9.
The Maine Medical Assessment Foundation (MMAF) has involved the participation of hundreds of physicians in study groups to analyze data on small-area variation and assess physician decision-making patterns. In 1991 the MMAF model was replicated across a tri-state area (Maine, New Hampshire, and Vermont) in an effort called the Outcomes Dissemination Project.
Five specialty study groups, each meeting three times a year, examined local and national utilization data and guidelines and research findings, participated in outcomes studies and patient education, and disseminated their findings through society presentations and other feedback efforts. Physician surveys indicated that all but one of the study groups were successful in making their existence and activities known to the broader medical community.
In the "Partnership Projects," the MMAF and relevant study groups, collaborating with a Maine business coalition, analyzed variations in utilization across employers, types of health plans (for example, health maintenance organization, preferred provider organization, fee-for-service), and small areas. Through this process, coalition members learned about small-area analysis and the implications of variations in utilization for cost and quality. The first year of the collaborative projects focused on several issues, including the development and dissemination of a practice guideline for the care of patients with chest pain; the dissemination of a practice guideline for the treatment of patients with acute low back pain; and a project designed to address cesarean section rates.
Innovative partnerships have been crafted to allow the tenets of the MMAF's working relationships with the medical community to remain intact, ensuring the ongoing interest and cooperation of hundreds of Maine physicians.
缅因州医学评估基金会（MMAF）已让数百名医生参与研究小组，以分析小区域差异数据并评估医生的决策模式。1991年，MMAF模型在一个三州地区（缅因州、新罕布什尔州和佛蒙特州）被复制，这一努力被称为“结果传播项目”。
五个专业研究小组，每年各会面三次，研究本地和全国的使用数据、指南及研究结果，参与结果研究和患者教育，并通过协会报告及其他反馈工作传播他们的研究结果。医生调查显示，除了一个研究小组外，其他所有研究小组都成功地让更广泛的医学界知晓了他们的存在和活动。
在“合作项目”中，MMAF及相关研究小组与缅因州商业联盟合作，分析了不同雇主、健康计划类型（例如，健康维护组织、优选提供者组织、按服务收费）和小区域之间的使用差异。通过这一过程，联盟成员了解了小区域分析以及使用差异对成本和质量的影响。合作项目的第一年聚焦于几个问题，包括制定和传播胸痛患者护理实践指南；传播急性下背痛患者治疗实践指南；以及一个旨在解决剖宫产率问题的项目。
已建立创新的合作伙伴关系，以使MMAF与医学界工作关系的原则保持不变，确保数百名缅因州医生持续保持兴趣并开展合作。
