A Method of Evaluating and Improving the Quality of Medical Care

Abstract
A method is outlined for evaluation of clinical performance of physicians associated with each of the 30 Health Insurance Plan (H.I.P.) medical groups. The review is made by recognized specialists in the fields of internal medicine, pediatrics, surgery, obstetrics-gynecology, radiology and pathology. They interview each physician, examine case re-cords and discuss the material with the physician. A score is then given for each case, the major areas being: record complete-ness, diagnostic work-up, treatment and follow-up. A completed report is submitted to each medical group with an analysis of the material studied, the performance of physicians and recom-mendations for improvement of any deficiencies. A follow-up team of appropriate specialists is available to help the groups carry out the recommendations.