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Editorial: Peer Influence and Opportunities for Physician Behavior Change
Journal of the National Cancer Institute ( IF 10.3 ) Pub Date : 2017-03-14 , DOI: 10.1093/jnci/djx009
Nancy L. Keating 1
Affiliation  

A large body of evidence demonstrates substantial area-level variations in intensity of care and health care spending in the United States. This variation is evident both across and within regions and exists for all types of care, including oncology care (1) and care identified to be of low value (2). Although the sources of variation have been long debated, recent evidence suggests that physicians’ beliefs, independent of organizational factors, are the key drivers in explaining area-level variations in health care spending (3). Physicians in the United States have substantial autonomy in decisions about care for patients, and thus their decisions are important drivers of health care utilization. Current alternate payment models target provider organizations in the hope that they create opportunities for physicians to influence and improve the value of care delivered by the organization. However, physician behavior is notoriously difficult to change, and relatively little evidence is available about the ability of physicians to directly influence the clinical decisions of their peers.

中文翻译:

社论:同行影响和医师行为改变的机会

大量证据表明,在美国,护理和医疗保健支出的强度在地区层面上存在很大差异。这种差异在整个区域内和区域内都是明显的,并且存在于所有类型的护理中,包括肿瘤护理(1)和被确定为低价值的护理(2)。尽管变异的根源已被争论不休,但最近的证据表明,医生的信念不受组织因素的影响,是解释医疗保健支出在地区层面差异的主要驱动力(3)。在美国,医生在决定患者护理方面具有很大的自主权,因此,他们的决定是卫生保健利用的重要驱动力。当前的替代支付模式以提供者组织为目标,希望它们为医生创造机会来影响和提高组织提供的护理价值。但是,众所周知,医生的行为很难改变,而且关于医生直接影响其同伴的临床决策的能力的证据也相对较少。
更新日期:2017-03-14
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