Azeem Majeed, MD
Potential Conflicts of Interest: Dr. Majeed is a general practitioner in the primary care practice of Dr Curran & Partners in London, United Kingdom. The Department of Primary Care & Public Health at Imperial College London has received funding from the NHS for research on pay-for-performance.
Majeed A.; Preventing Unintended Consequences of Quality Measurement for Venous Thromboembolism Prophylaxis. Ann Intern Med. 2012;156:327-328. doi: 10.7326/0003-4819-156-4-201202210-00024
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Published: Ann Intern Med. 2012;156(4):327-328.
TO THE EDITOR:
In recent years, pay-for-performance programs and public reporting of provider performance have become integral components of strategies to improve the quality of health care in many countries. However, as highlighted by Baker and Qaseem (1), quality measurement can also have unintended consequences. Among the measures that these authors advocate to reduce such consequences is allowing physicians to report exceptions for not following a recommendation. Although exception reporting should be an essential component of quality measurement to ensure that patients who will not benefit from an intervention (such as those who are terminally ill) are not treated inappropriately, it is also important to monitor exception reports at both patient and provider levels.
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