Measuring the quality of care provided to community dwelling vulnerable elders dually enrolled in Medicare and Medicaid.
Measuring the quality of care provided to community dwelling vulnerable elders dually enrolled in Medicare and Medicaid.
复制标题
衡量向同时参加医疗保险和医疗补助的社区居住弱势老年人提供的护理质量。
DOI：
10.1097/mlr.0b013e318127143e
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发表时间：
2007
期刊：
影响因子：
3
通讯作者：
Wenger,NeilS
中科院分区：
文献类型：
--
作者：
Zingmond,DavidS;Wilber,KathleenH;Maclean,CatherineH;Wenger,NeilS
目的：为了测量护理质量在一个社区居住的弱势老年人口使用行政数据应用质量指标（QIs）从评估护理弱势Elders project.Design，设置，和Participants：队列研究的社区居住的双重enrollees在医疗保险和医疗补助，年龄75岁及以上，生活在19个加州县在1999年和2000年。测量的护理条件（如，心力衰竭）和干预类型（如，药物使用），并确定无法测量的医疗保险和医疗补助claims.Results：共43的230个QIs使用链接索赔数据捕获的护理提供43个QIs。100，528例患者触发了930，753个QI（9.3个QI/人）。总体QI通过率（即成功接受护理）为65%。合格率最高的QIs测量了避免不良药物和适当的药物使用。缺血性心脏病、中风和骨质疏松症的QI通过率不到一半。几个QIs旨在老年护理可以测量，没有评估咨询，病史，或信息continuance.Conclusions：使用索赔数据派生的护理质量的过程措施是可行的，为弱势老年人口，但需要开发的数据元素集中在老年护理。QIs可以应用于本研究中包括的老年患者，确定了几个需要改进的护理领域。
Objective: To measure the quality of care in a community-dwelling vulnerable geriatric population using administrative data to apply quality indicators (QIs) from the Assessing Care of Vulnerable Elders project.Design, Setting, and Participants: Cohort study of community-dwelling dual enrollees in Medicare and Medicaid, age 75 years and older, living in 19 California counties in 1999 and 2000.Main Outcome Measure: Measurement of care provided for 43 QIs by condition (eg, heart failure) and by intervention type (eg, medication use), and identification of care inaccessible to measurement by linked Medicare and Medicaid claims.Results: A total of 43 out of 230 QIs were captured using linked claims data. The 100,528 patients triggered 930,753 QIs (9.3 QIs/person). The overall QI pass rate (ie, successful receipt of care) was 65%. QIs with the highest pass rates measured avoidance of adverse medications and appropriate medication use. Fewer than half of the QIs were passed for ischemic heart disease, stroke, and osteoporosis. Few QIs aimed at geriatric care could be measured and none assessed counseling, history taking, or information continuity.Conclusions: The use of claims data-derived quality-of-care process measures is feasible for the vulnerable older population, but requires development of data elements focused on geriatric care. QIs that could be applied to the older patients included in this study identified several areas of care that need improvement.