Receipt of Disease-Modifying Antirheumatic Drugs Among Patients With Rheumatoid Arthritis in Medicare Managed Care Plans
Receipt of Disease-Modifying Antirheumatic Drugs Among Patients With Rheumatoid Arthritis in Medicare Managed Care Plans
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DOI：
10.1001/jama.2011.67
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发表时间：
2011-02-02
影响因子：
120.7
通讯作者：
Yazdany, Jinoos
中科院分区：
文献类型：
--
作者：
Schmajuk, Gabriela;Trivedi, Amal N.;Yazdany, Jinoos
背景2005年，医疗保健效果数据和信息集（HEDIS）引入了一种质量指标来评估类风湿关节炎（RA）患者接受疾病缓解抗风湿药物（DMARDs）的情况。我们分析了93143例患者的个人水平HEDIS数据，这些患者至少65岁，在一个测量年内（2005-2008年期间）至少有2次RA诊断。Logistic回归模型与广义估计方程，以确定与DMARD接收和Logistic回归相关的因素，用于调整健康计划的性能，为案件mix.Main结果测量接收或nonreceipt的DMARD.Results患者的平均年龄为74岁，75%是女性和82%是白色。2005年，HEDIS衡量RA的总体表现为59%，2008年增加到67%（P代表趋势
Context In 2005, the Healthcare Effectiveness Data and Information Set (HEDIS) introduced a quality measure to assess the receipt of disease-modifying antirheumatic drugs (DMARDs) among patients with rheumatoid arthritis (RA).Objective To identify sociodemographic, community, and health plan factors associated with DMARD receipt among Medicare managed care enrollees.Design, Setting, and Participants We analyzed individual-level HEDIS data for 93 143 patients who were at least 65 years old with at least 2 diagnoses of RA within a measurement year (during 2005-2008). Logistic regression models with generalized estimating equations were used to determine factors associated with DMARD receipt and logistic regression was used to adjust health plan performance for case mix.Main Outcome Measures Receipt or nonreceipt of DMARD.Results The mean age of patients was 74 years; 75% were women and 82% were white. Overall performance on the HEDIS measure for RA was 59% in 2005, increasing to 67% in 2008 (P for trend