Quality of Outpatient Care Has Not Consistently Improved Over Last Decade

MedicalResearch.com Interview with:

David Michael Levine M.D.,M.A. Division of General Internal Medicine and Primary Care Brigham and Women’s Hospital Boston, Massachusetts

Dr. David Levine

David Michael Levine M.D.,M.A.
Division of General Internal Medicine and Primary Care
Brigham and Women’s Hospital
Boston, Massachusetts

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: About a decade ago, researchers showed that Americans only received half of recommended health care. Since then, national, regional, and local initiatives have attempted to improve quality and patient experience, but there is incomplete information about whether such efforts have been successful.

We found that over the past decade the quality of outpatient care has not consistently improved, while patient experience has improved.

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Heart Failure Care in Patients Admitted for Other Diagnoses

Saul Blecker, MD, MHS Department of Population Health, NYU School of Medicine, New York, NY Department of Medicine, NYU School of Medicine, New York, NYMedicalResearch.com Interview with:
Saul Blecker, MD, MHS
Department of Population Health, NYU School of Medicine
Department of Medicine, NYU School of Medicine, New York, NY

 

MedicalResearch.com: What are the main findings of the study?

Dr. Blecker: Inpatient quality of care has focused primarily on patients with acute heart failure, commonly identified by principal discharge diagnosis code. However, patients with heart failure are commonly hospitalized for other causes and should benefit from many of the same treatments.

We found that in our sample, as compared to patients with a principal diagnosis of heart failure, heart failure patients hospitalized with a non–heart failure diagnosis had lower rates of guideline-concordant care, including assessment of left ventricular function and prescription for an ACE inhibitor or ARB, at time of discharge. This is important as our study suggests that these therapies were associated with reduced mortality for patients hospitalized with heart failure, regardless of the reason for hospitalization.

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Medicare: Potential Cost & Quality Gains Using Cost-Effectiveness Evidence to Reallocate Expenditures

James D. Chambers, PhD, MPharm

Assistant Professor
The Center for the Evaluation of Value and Risk in Health
Institute for Clinical Research and Health Policy Studies
TuftsMedicalCenter

www.cearegistry.org

MedicalResearch.com: What are the main findings of the study?

Dr. Epstein: Using cost-effectiveness evidence to help inform the allocation of expenditures for medical interventions in Medicare has the potential to generate substantial aggregate health gains for the Medicare population with no increases in spending.

Reallocating expenditures for interventions in Medicare using cost-effectiveness evidence led to an estimated aggregate health gain of 1.8 million quality-adjusted life years (QALYs), a measure of health gain that accounts for both quality and quantity of life.

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