| Titre : | Quality of medical care delivered to medicare beneficiaries : A profile at state and national levels. (2000) |
| Auteurs : | Stephen-F JENCKS ; David-R ARDAY ; Dale-R BURWEN ; Timothy CUERDON ; Barbara FLEMING ; Peter-M HOUCK ; Annette-E KUSSMAUL ; David-S NILASENA ; Diana-L ORDIN ; Health Care Financing Administration. Baltimore. MD. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 284, n° 13, 2000) |
| Pagination : | 1670-1676 |
| Langues: | Anglais |
| Mots-clés : | Soins santé primaire ; Relation médecin malade ; Assurance maladie ; Stratégie ; Homme |
| Résumé : | [BDSP. Notice produite par INIST 38xR0xuA. Diffusion soumise à autorisation]. Context Despite condition-specific and managed care-specific reports, no systematic program has been developed for monitoring the quality of medical care provided to Medicare beneficiaries. Objective To create a monitoring system for a range of measures of clinical performance that supports quality improvement and provides repeated, reliable estimates at the national and state levels for fee-for-service (FFS) Medicare beneficiaries. Design, Setting, and Participants National study of repeated, cross-sectional observational data collected in 1997-1999 on all Medicare FFS beneficiaries or on a representative sample of beneficiaries with a particular condition. Data were collected using medical record abstraction for inpatient care, analysis of Medicare claims for some ambulatory services, and surveys for immunization rates. Separate samples were drawn for each topic for each state. Main Outcome Measures Beneficiary patients'receipt of 24 process-of-care measures related to primary prevention, secondary prevention, or treatment of 6 medical conditions (acute myocardial infarction, breast cancer, diabetes mellitus, heart failure, pneumonia, and stroke) for which there is strong scientific evidence and professional consensus that the process of care either directly improves outcomes or is a necessary step in a chain of care that does so. (...) |
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