Measuring Value in Internal Medicine Residency Training Hospitals Using Publicly Reported Measures

Adam Schickedanz, Reshma Gupta, Vineet M. Arora, Clarence H. Braddock

Research output: Contribution to journalArticlepeer-review

Abstract

Graduate medical education (GME) lacks measures of resident preparation for high-quality, cost-conscious practice. The authors used publicly reported teaching hospital value measures to compare internal medicine residency programs on high-value care training and to validate these measures against program director perceptions of value. Program-level value training scores were constructed using Centers for Medicare & Medicaid Services Value-Based Purchasing (VBP) Program hospital quality and cost-efficiency data. Correlations with Association of Program Directors in Internal Medicine Annual Survey high-value care training measures were examined using logistic regression. For every point increase in program-level VBP score, residency directors were more likely to agree that GME programs have a responsibility to contain health care costs (adjusted odds ratio [aOR] 1.18, P =.04), their faculty model high-value care (aOR 1.07, P =.03), and residents are prepared to make high-value medical decisions (aOR 1.07, P =.09). Publicly reported clinical data offer valid measures of GME value training.

Original languageEnglish (US)
Pages (from-to)604-613
Number of pages10
JournalAmerican Journal of Medical Quality
Volume33
Issue number6
DOIs
StatePublished - Nov 1 2018
Externally publishedYes

Keywords

  • cost-effectiveness
  • graduate medical education
  • quality
  • value

ASJC Scopus subject areas

  • Health Policy

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