ROBERT H. BROOK, M.D., Sc.D.; KATHLEEN N. WILLIAMS, M.A.
Grant support: in part by a Health Insurance Study Grant from the U.S. Department of Health, Education, and Welfare and a contract from Health Care Management Systems. The opinions and conclusions expressed herein are solely those of the authors and should not be construed as representing the opinions or policies of the supporting agencies.
▸Requests for reprints should be addressed to Robert H. Brook, M.D.; The Rand Corporation; 1700 Main Street; Santa Monica, CA 90406.
BROOK R., WILLIAMS K.; Effect of Medical Care Review on the Use of Injections: A Study of the New Mexico Experimental Medical Care Review Organization. Ann Intern Med. 1976;85:509-515. doi: 10.7326/0003-4819-85-4-509
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Published: Ann Intern Med. 1976;85(4):509-515.
Evaluation of peer review activities in the New Mexico Medicaid program (1971 to 1973) showed that it can affect aspects of quality, that is, the appropriateness of the use of injections as judged by medical criteria. Use of injections, nearly 50% of which were antibiotics, declined by more than 60%, from 41 to 16 per 100 ambulatory visits. Still, at the end of the study, 40% of the injections given were considered medically unnecessary. Analyses showed that  groups used injections more appropriately;  for solo physicians, being board-certified, being a doctor of medicine, and being a pediatrician were all associated with more proper use of injections;  6% of the physicians gave 40% of the medically unnecessary injections, but even their behavior changed dramatically for the better as a result of the peer review system.
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