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Whether Chronic Diseases Are Diagnosed May Depend on Where You Live
Date:3/15/2011

penalize doctors for being cautious and prudent and not overspending on tests and imaging studies or being overly aggressive."

One potential solution is the increasing use of electronic health records, which will enable data from patients charts to be more easily and readily analyzed when doing risk adjustment, Jha said. Currently, with so many physicians still using paper records, risk adjustment is done using insurance claims data, which is incomplete and doesn't get into great detail about how sick patients actually are.

"We want to be able to differentiate between the one who is really sick with lung disease vs. someone who has something minor but is otherwise OK," Jha said. "You can't get it from claims or billing data, but you can get that from clinical records, and the broader use of electronic health records will help that."

More information

For more on chronic illness care, go to the Agency for Healthcare Research.

SOURCES: Ashish Jha, M.D., MPH, associate professor, health policy, Harvard School of Public Health, Boston; John Wennberg, M.D, M.P.H., professor emeritus, Dartmouth College, Hanover, N.H.; March 16, 2011, Journal of the American Medical Association


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