| Titre : | Improving the quality of care for Medicare patients with acute myocardial infarction results from the cooperative cardiovascular project. (1998) |
| Auteurs : | T.A. MARCINIAK ; R.M. ALLMAN ; E.F. ELLERBECK ; J.A. GOLD ; S.F. JENCKS ; C.I. KIEFE ; T.F. KRESOWIK ; H.M. KRUMHOLZ ; M.J. RADFORD ; R.A. VOGEL ; Alabama Quality Assurance Foundation and the Department of Veterans Affairs. Birmingham. USA ; Connecticut Peer Review Organization. Middletown. USA ; Health Care Financing Administration. Baltimore Md. USA ; Iowa Foundation for Medical Care. Des Moines. USA ; MetaStar Inc. Madison Wis. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 279, n° 17, 1998) |
| Pagination : | 1351-1357 |
| Langues: | Anglais |
| Mots-clés : | Infarctus ; Myocarde ; Qualité ; Soins ; Programme santé ; Etats Unis ; Amérique du Nord ; Amérique ; Létalité ; Thérapeutique ; Evolution ; Pronostic ; Etude comparée ; Homme ; Appareil circulatoire [pathologie] ; Cardiopathie coronaire ; Myocarde [pathologie] ; Medicare |
| Résumé : | [BDSP. Notice produite par INIST R0x2uFrQ. Diffusion soumise à autorisation]. Context-Medicare has a legislative mandate for quality assurance, but the effectiveness of its population-based quality improvement programs has been difficult to establish. Objective. - To improve the quality of care for Medicare patients with acute myocardial infarction. Design. Quality improvement project with baseline measurement, feedback, remeasurement, and comparison samples. Setting. - All acute care hospitals in the United States. Patients. - Preintervention and postintervention samples included all Medicare patients in Alabama, Connecticut, Iowa, and Wisconsin discharged with principal diagnoses of acute myocardial infarctions during 2 periods, June 1992 through December 1992 and August 1995 through November 1995. Indicator comparisons were made with a random sample of Medicare patients in the rest of the nation discharged with acute myocardial infarctions from August 1995 through November 1995. Mortality comparisons involved all Medicare patients nationwide with inpatient claims for acute myocardial infarctions during 2 periods, June 1992 through May 1993 and August 1995 through July 1996. Intervention. - Data feedback by peer review organizations. Main Outcome Measures. - Quality indicators derived from clinical practice guidelines, length of stay, and mortality. Results. - Performance on all quality indicators improved significantly in the 4 pilot states. (...) |
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