Jm. Bronstein et al., HOW RURAL PHYSICIANS COMPARE ON COST AND QUALITY MEASURES FOR MEDICAID AMBULATORY CARE EPISODES, The Journal of rural health, 13(2), 1997, pp. 126-135
This study compares the costs and quality of episodes of care for two
common childhood illnesses, urinary tract infections (UTI) and otitis
media (OM), across providers practicing in rural, small town, and urba
n counties in Alabama in 1992. The data source is Medicaid claims data
for children under age 8 who were treated for these conditions. The s
tudy found that episodes cared for by rural providers were less expens
ive than episodes cared for in other locations, both because fewer rur
al episodes included outpatient facility charges and because fewer anc
illary services were provided in rural settings. Researchers also foun
d that, even controlling for physician characteristics and patient dem
ographic and utilization factors, rural episodes were significantly le
ss likely to include two process measures of quality of care: fewer ru
ral UTI episodes included urine cultures, and fewer rural OM episodes
included follow-up visits. This study suggests that, as a group, rural
physicians may have a favorable cost profile but a potentially unfavo
rable care content profile, compared with other physicians. Both pract
ice profile data and explicit care recommendations need to be availabl
e to physicians so they can monitor, defend, or alter their clinical p
ractices.