| Titre : | Quality of care for patients with rheumatoid arthritis. (2000) |
| Auteurs : | C.H. MACLEAN ; R.H. BROOK ; B. LEAKE ; R. LOUIE ; D.F. MCCAFFREY ; H.E. PAULUS ; P.G. SHEKELLE ; Department of Medicine. University of California. Los Angeles. USA ; Rand Health Program. Santa Monica. CA. USA ; School of Public Health. University of California. Los Angeles. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 284, n° 8, 2000) |
| Pagination : | 984-992 |
| Langues: | Anglais |
| Mots-clés : | Polyarthrite rhumatoïde ; Soins intégrés ; Epidémiologie ; Homme ; Système ostéoarticulaire [pathologie] ; Immunopathologie ; Maladie autoimmune |
| Résumé : | [BDSP. Notice produite par INIST 88RR0x7n. Diffusion soumise à autorisation]. Context Patients with rheumatoid arthritis are at risk for substantial morbidity because of their arthritis and premature mortality due to comorbid diseases. However, little is known about the quality of the health care that these patients receive. Objective To assess the quality of the health care that rheumatoid arthritis patients receive for their arthritis, comorbid diseases, and health care maintenance and to determine the effect of patterns of specialty care on quality. Design, Setting, and Participants Historical cohort study of 1355 adult rheumatoid arthritis patients enrolled in the fee-for-service or discounted fee-for-service plans of a nationwide US insurance company. Patients were identified and followed up through administrative data between 1991 and 1995. A Main Outcome Measures Quality scores for arthritis, comorbid disease, and health care maintenance were developed from performance on explicit process measures that related to each of these domains and described the percentage of indicated health care processes performed within each domain during each person-year of the study. Results During 4598 person-years of follow-up, quality scores were 62% (95% confidence interval [CI], 61% - 64%) for arthritis care, 52% (95% CI, 49% - 55%) for comorbid disease care, and 42% (95% CI, 40% - 43%) for health care maintenance. Across domains, care patterns including relevant specialists yielded performance scores 30% to 187% higher than those that did not (P<. (...) |
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