Change in the quality of care delivered to Medicare beneficiaries, 1998-1999 to 2000-2001
Change in the quality of care delivered to Medicare beneficiaries, 1998-1999 to 2000-2001
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DOI：
10.1001/jama.289.3.305
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发表时间：
2003-01-15
影响因子：
120.7
通讯作者：
Cuerdon, T
中科院分区：
文献类型：
--
作者：
Jencks, SF;Huff, ED;Cuerdon, T
Context Despite widespread concern regarding the quality and safety of healthcare, and a Medicare Quality Improvement Organization (QIO) program intended to improve that care in the United States, there is only limited information on whether quality is improving.Objective To track national and state-level changes in performance on 22 quality indicators for care of Medicare beneficiaries.Design, Patients, and Setting National observational cross-sectional studies of national and state-level fee-for-service data for Medicare beneficiaries during 19981999 (baseline) and 2000-2001 (follow-up).Main Outcome Measures Twenty-two QIO quality indicators abstracted from statewide random samples of medical records for inpatient fee-for-service care and from Medicare beneficiary, surveys or Medicare claims for outpatient care. Absolute improvement is defined as the change in performance from baseline to follow-up (measured in percentage points for all indicators except those measured in minutes); relative improvement is defined as the absolute improvement divided by the difference between the baseline performance and perfect performance (100%).Results The median state's performance improved from baseline to follow-up on 20 of the 22 indicators. In the median state, the percentage of patients receiving appropriate care on the median indicator increased from 69.5% to 73.4%, a 12.8% relative improvement. The average relative improvement was 19.9% for outpatient indicators combined and 11.9% for inpatient indicators combined (P
