The quality of health care delivered to adults in the United States. Export

@article{citeulike:248992, abstract = {BACKGROUND: We have little systematic information about the extent to which standard processes involved in health care--a key element of quality--are delivered in the United States. METHODS: We telephoned a random sample of adults living in 12 metropolitan areas in the United States and asked them about selected health care experiences. We also received written consent to copy their medical records for the most recent two-year period and used this information to evaluate performance on 439 indicators of quality of care for 30 acute and chronic conditions as well as preventive care. We then constructed aggregate scores. RESULTS: Participants received 54.9 percent (95 percent confidence interval, 54.3 to 55.5) of recommended care. We found little difference among the proportion of recommended preventive care provided (54.9 percent), the proportion of recommended acute care provided (53.5 percent), and the proportion of recommended care provided for chronic conditions (56.1 percent). Among different medical functions, adherence to the processes involved in care ranged from 52.2 percent for screening to 58.5 percent for follow-up care. Quality varied substantially according to the particular medical condition, ranging from 78.7 percent of recommended care (95 percent confidence interval, 73.3 to 84.2) for senile cataract to 10.5 percent of recommended care (95 percent confidence interval, 6.8 to 14.6) for alcohol dependence. CONCLUSIONS: The deficits we have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public. Strategies to reduce these deficits in care are warranted.}, address = {RAND, Santa Monica, Calif 90407, USA. beth\_mcglynn@rand.org}, author = {McGlynn, E. A. and Asch, S. M. and Adams, J. and Keesey, J. and Hicks, J. and DeCristofaro, A. and Kerr, E. A.}, citeulike-article-id = {248992}, citeulike-linkout-0 = {http://dx.doi.org/10.1056/NEJMsa022615}, citeulike-linkout-1 = {http://content.nejm.org/cgi/content/abstract/348/26/2635}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/12826639}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=12826639}, day = {26}, doi = {10.1056/NEJMsa022615}, issn = {1533-4406}, journal = {The New England journal of medicine}, keywords = {preventivemedicine}, month = {June}, number = {26}, pages = {2635--2645}, posted-at = {2006-04-09 15:35:59}, priority = {5}, title = {The quality of health care delivered to adults in the United States.}, url = {http://dx.doi.org/10.1056/NEJMsa022615}, volume = {348}, year = {2003} }

TY - JOUR ID - citeulike:248992 L3 - citeulike-article-id:248992 N2 - BACKGROUND: We have little systematic information about the extent to which standard processes involved in health care--a key element of quality--are delivered in the United States. METHODS: We telephoned a random sample of adults living in 12 metropolitan areas in the United States and asked them about selected health care experiences. We also received written consent to copy their medical records for the most recent two-year period and used this information to evaluate performance on 439 indicators of quality of care for 30 acute and chronic conditions as well as preventive care. We then constructed aggregate scores. RESULTS: Participants received 54.9 percent (95 percent confidence interval, 54.3 to 55.5) of recommended care. We found little difference among the proportion of recommended preventive care provided (54.9 percent), the proportion of recommended acute care provided (53.5 percent), and the proportion of recommended care provided for chronic conditions (56.1 percent). Among different medical functions, adherence to the processes involved in care ranged from 52.2 percent for screening to 58.5 percent for follow-up care. Quality varied substantially according to the particular medical condition, ranging from 78.7 percent of recommended care (95 percent confidence interval, 73.3 to 84.2) for senile cataract to 10.5 percent of recommended care (95 percent confidence interval, 6.8 to 14.6) for alcohol dependence. CONCLUSIONS: The deficits we have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public. Strategies to reduce these deficits in care are warranted. IS - 26 JF - The New England journal of medicine SN - 1533-4406 AD - RAND, Santa Monica, Calif 90407, USA. beth_mcglynn@rand.org EP - 2645 TI - The quality of health care delivered to adults in the United States. VL - 348 SP - 2635 KW - preventivemedicine AU - McGlynn, EA AU - Asch, SM AU - Adams, J AU - Keesey, J AU - Hicks, J AU - DeCristofaro, A AU - Kerr, EA PY - 2003/06/26/ UR - http://dx.doi.org/10.1056/NEJMsa022615 ER -