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  1. Variation in office-based quality : a claims-based profile of care provided to medicare patients with diabetes.

    Article - En anglais

    Objectives

    - To demonstrate that claims data « profiling » can be used as an ongoing method to support ambulatory care quality improvement ; to measure the quality of office-based care provided to elderly patients with diabetes in three states ; and to identify factors associated with better attainment of quality standards.

    Study Design

    - A cross-sectional study based on a 100% sample of the Medicare claims (Part B and Part A) submitted between July 1,1990, and June 30,1991.

    Setting

    - All primary care practices (both solo and group) actively seeing Medicare patients with diabetes in Alabama, lowa, and Maryland (n=2980).

    Patients

    - All elderly (=65 years) Medicare patients seen by the study physicians and assigned a diagnosis of diabetes (n=97 388) by any office-based physician during the year.

    Results

    - Based on analyses of services provided in the ambulatory setting, we found that 84% of diabetics did not appear to receive the recommended hemoglobin A1C measurement, 54% did not see an ophthalmologist, and 45% received no cholesterol screening.

    Patients of general practitioners were less likely to meet recommended quality criteria than patients of internists or family practitioners.

    Patients receiving care from rural practitioners were less likely to receive services, either recommended or not, than those in urban locations.

    Conclusions

    - Elderly patients with diabetes do not appear to be receiving optimal care.

    This study undersc.

    Mots-clés Pascal : Evaluation performance, Qualité, Analyse coût efficacité, Soin, Etude comparative, Demande, Réponse, Diabète, Vieillard, Etats Unis, Homme, Amérique du Nord, Amérique, Endocrinopathie

    Mots-clés Pascal anglais : Performance evaluation, Quality, Cost efficiency analysis, Care, Comparative study, Demand, Response, Diabetes mellitus, Elderly, United States, Human, North America, America, Endocrinopathy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0339411

    Code Inist : 002B30A01C. Création : 01/03/1996.