A Two‐Step Method to Identify Positive Deviant Physician Organizations of Accountable Care Organizations with Robust Performance Management Systems
提出一种两步法，利用第三次全国医师组织调查数据，通过百分位截点识别责任医疗组织中绩效管理系统超出预期的积极偏离组织，发现高比例弱势患者会制约系统发展。
OBJECTIVE: To identify positive deviant (PD) physician organizations of Accountable Care Organizations (ACOs) with robust performance management systems (PMSYS). DATA SOURCE: Third National Survey of Physician Organizations (NSPO3, n = 1,398). STUDY DESIGN: Organizational and external factors from NSPO3 were analyzed. DATA COLLECTION/EXTRACTION METHODS: Linear regression estimated the association of internal and contextual factors on PMSYS. Two cutpoints (75th/90th percentiles) identified PDs with the largest residuals and highest PMSYS scores. PRINCIPAL FINDINGS: A total of 65 and 41 PDs were identified using 75th and 90th percentiles cutpoints, respectively. The 90th percentile more strongly differentiated PDs from non-PDs. Having a high proportion of vulnerable patients appears to constrain PMSYS development. CONCLUSIONS: Our PD identification method increases the likelihood that PD organizations selected for in-depth inquiry are high-performing organizations that exceed expectations.