Abstract:
BACKGROUND:In 1999, the US Congress mandated the Agency for Healthcare Research and Quality (AHRQ), Department of Health and Human Services (DHHS), to report annually to the nation about healthcare quality. One chapter in the National Healthcare Quality Report (NHQR) is focused on patient safety. OBJECTIVES:The objectives of this study were to describe the challenges in reporting the national status on patient safety for the first NHQR and discuss emerging opportunities to improve the comprehensiveness and reliability of future reporting. RESEARCH DESIGN:This study is a selective review of definitions, frameworks, data sources, measures, and emerging developments for assessing patient safety in the United States. RESULTS:Available data and measures for patient safety assessment in the nation are inadequate, especially for comparing regions and subpopulations and for trend analysis. However, many opportunities are emerging from the recently increased investments in patient safety research and many ongoing safety improvement efforts in the private sector and at the federal, state, and local government levels. CONCLUSION:There are many challenges in assessing national performance on patient safety today. Ongoing developments on multiple fronts will provide data and measures for more accurate and more comprehensive assessments of patient safety for future NHQRs.
journal_name
Med Carejournal_title
Medical careauthors
Zhan C,Kelley E,Yang HP,Keyes M,Battles J,Borotkanics RJ,Stryer Ddoi
10.1097/00005650-200503001-00007keywords:
subject
Has Abstractpub_date
2005-03-01 00:00:00pages
I42-7issue
3 Suppleissn
0025-7079issn
1537-1948pii
00005650-200503001-00007journal_volume
43pub_type
杂志文章,评审相关文献
MEDICAL CARE文献大全abstract:BACKGROUND:Utility techniques are the most commonly used means to assess patient preferences for health outcomes. However, whether utility techniques produce valid measures of preference has been difficult to determine in the absence of a gold standard. OBJECTIVE:To introduce and demonstrate two methods that can be us...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199906000-00007
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Variance reduction is sometimes considered as a goal of clinical quality improvement. Variance among physicians, hospitals, or health plans has been evaluated as the proportion of total variance (or intraclass correlation, ICC) in a quality measure; low ICCs have been interpreted to indicate low potential fo...
journal_title:Medical care
pub_type: 杂志文章,多中心研究
doi:10.1097/MLR.0b013e3181c15a6e
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Young men who have sex with men (YMSM) have the highest rates of human immunodeficiency virus (HIV) infection in the United States. Decades into the HIV epidemic, the relationships that YMSM-serving health and social organizations have with one another has not been studied in depth. OBJECTIVES:The aim of th...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000595
更新日期:2017-02-01 00:00:00
abstract::Effective physician involvement in quality assurance in hospitals is necessary both to identify problems in patient care and to bring about problem resolution. This report describes a controlled, longitudinal study designed to measure effects on physician performance of involving physicians in setting medical audit cr...
journal_title:Medical care
pub_type: 临床试验,杂志文章
doi:10.1097/00005650-198412000-00006
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:The use of league tables during the last decade has frequently been employed to assess quality in health care. However, few studies have attempted to assess quality by quantifying the variability across the organizational units or attempted to investigate whether the units are the correct context that really...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31820325c5
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Given strict residency controls and geographic imbalances in health care resources, China may experience serious urban-rural health disparities. OBJECTIVES:To investigate urban-rural disparities in the patterns of health status and health care utilization in China and to examine the evolution of these dispa...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181adcc32
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Collaborative Chronic Care Models represent an evidence-based way to structure care for chronic conditions, including mental health conditions. Few studies, however, have examined the cost implications of collaborative care for mental health. OBJECTIVE:We aimed to conduct an economic analysis of implementin...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000001372
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:The quality of care for Medicare beneficiaries with diabetes remains suboptimal. The contributing factors at the physician level are not well characterized, especially the relationship of patient volume and physician performance. OBJECTIVE:We sought to determine associations between the number of Medicare d...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/01.mlr.0000233685.22497.cf
更新日期:2006-12-01 00:00:00
abstract::The authors compared the continuity of care that family physicians, general internists, and medical subspecialists provided to their adult primary care patients. The 40 study physicians came from large, private multispecialty practices in the San Francisco Bay Area. The three physician types did not differ significant...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198501000-00007
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:: Previous research suggests, but does not definitively establish, that a high level of uninsurance in a community may negatively affect access to and quality of health care for insured persons. OBJECTIVE:: To assess the effect of the level of uninsurance in a community on access to and satisfaction with ca...
journal_title:Medical care
pub_type: 杂志文章,多中心研究
doi:10.1097/MLR.0b013e31822dc7f4
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:The intensive and varied services required by high-need patients have inspired a number of new care delivery models; however, evidence of their effectiveness is mixed. This study evaluated whether augmenting a patient-centered medical home (PCMH) with intensive outpatient management enhances high-need patient...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0000000000000833
更新日期:2018-01-01 00:00:00
abstract::The purpose of this study was to develop a "time-insensitive" predictive instrument (TIPI) for acute hospital mortality due to congestive heart failure. In Phase 1, based on prospectively collected data on 401 congestive heart failure patients among 5,773 study patients who presented to six New England hospitals over ...
journal_title:Medical care
pub_type: 杂志文章,多中心研究
doi:10.1097/00005650-199410000-00005
更新日期:1994-10-01 00:00:00
abstract::Health-related quality-of-life (HRQOL) measures are becoming increasingly important for evaluating the effectiveness of medical interventions and assessing the health of populations. Preference-based instruments, a subset of HRQOL measures, allow comparisons of overall health status in populations and in clinical sett...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199602000-00008
更新日期:1996-02-01 00:00:00
abstract::Each physician's ability to treat disease is limited by his/her ability to discriminate among patients on the basis of risk. The relationship of physician expectation of outcome (prognosis) to actual outcome and to cost were determined for 1,757 patients seeking primary care. Outcome was measured by a seven-level func...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198202000-00005
更新日期:1982-02-01 00:00:00
abstract:BACKGROUND:Several quality assessment systems use administrative data to identify postoperative complications, with uncertain validity. OBJECTIVES:To determine how accurately postoperative complications are reported in administrative data, whether accuracy varies systematically across hospitals, and whether serious co...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-200210000-00004
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVES:Building on Andersen's behavioral model for the utilization of health care services, we examined factors associated with utilization of physician and hospital services among adults in Canada and the United States, with a focus on socioeconomic status (enabling resources in Andersen's framework). METHODS:Usi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e3181adcbe9
更新日期:2009-11-01 00:00:00
abstract::Previous research has neglected to delineate pediatric nurse practitioner (PNP) roles in tertiary care settings (TCS). New PNP roles have developed as TCS seek cost-effective solutions to providing quality patient care and to meeting new demands for outpatient care. The authors evaluated the roles of 11 PNPs in eight ...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198604000-00005
更新日期:1986-04-01 00:00:00
abstract::This study compares health insurance payments and patient utilization patterns for episodes of care for common lumbar and low back conditions treated by chiropractic and medical providers. Using 2 years of insurance claims data, this study examines 6,183 patients who had episodes with medical or chiropractic first-con...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199603000-00001
更新日期:1996-03-01 00:00:00
abstract::The acceptability of satisfaction as a quality indicator is qualified by several well known measurement problems. This study examines the variability in satisfaction evaluations related to different measurement methods and the effect of response biases on reported satisfaction. Satisfaction evaluations using seven dif...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199504000-00006
更新日期:1995-04-01 00:00:00
abstract::To enhance the efficient utilization of health providers, medical care researchers are increasingly concerned with the measurement of task performance. One job analysis methodology that is widely used is the task inventory technique, characterized by retrospective self-reporting. The purpose of this study was to valid...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197502000-00002
更新日期:1975-02-01 00:00:00
abstract::The authors assess the factorial validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) for use in a clinical sample of disadvantaged, older adults with significant comorbidities. Confirmatory factor analysis was performed using LISREL VIII on data obtained from baseline face-to-face interview...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199606000-00004
更新日期:1996-06-01 00:00:00
abstract::This article describes the statistical methods and strategies to be used in establishing the linkages between processes and structures of care with risk-adjusted outcomes in a large multicenter Veterans Affairs cooperative study in health services of patients undergoing cardiac surgery. The statistical analyses consis...
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/00005650-199510001-00005
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:Seizures and epilepsy are common in older adults especially in some minorities. Despite the importance of medical care to maximize seizure control, little is known about its quality across racial groups. One indicator of quality care is the receipt of electroencephalograms (EEG), and magnetic resonance imagi...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/MLR.0b013e31824ebdc4
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVES:This study compared Department of Veterans Affairs (VA) and non-VA mental health service use among male and female veterans. Because female veterans are a distinct minority in VA, it was hypothesized that they would be less likely to use VA mental health care than would male veterans. METHODS:Using data fro...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-199811000-00002
更新日期:1998-11-01 00:00:00
abstract::A clustering method for the analysis of ambulatory morbidity data is presented. This approach reduces spurious variations resulting from idiosyncratic diagnosis labeling and coding habits of physicians and facilitates the analysis of the content of ambulatory medical care through the use of aggregate morbidity data. T...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198301000-00008
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:Current health care reform efforts are focused on reorganizing health care systems to reduce waste in the US health care system. OBJECTIVE:To compare rates of overuse in different health care systems and examine whether certain systems of care or insurers have lower rates of overuse of health care services....
journal_title:Medical care
pub_type: 杂志文章,评审
doi:10.1097/MLR.0b013e31828dbafe
更新日期:2013-06-01 00:00:00
abstract:CONTEXT:Black patients and Hispanic patients receive carotid endarterectomy (CEA) at lower rates than white patients. It is unclear whether worse surgical outcomes are influencing clinical decision-making regarding use of the operation among minority group patients. OBJECTIVE:To determine if there are racial differenc...
journal_title:Medical care
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::Seven general surgeons in a prepaid group practice previously shown to have a mean operative work load of 9.2 hernia equivalents (HE) per week were found to have a standardized mean daytime working week of 56.2 hours, exclusive of evening activities of which 50.7 hours were devoted to professional activities. The surg...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-197610000-00003
更新日期:1976-10-01 00:00:00
abstract::It is generally agreed that patients have a right to be adequately informed. However, little is known about the extent to which doctors and patients agree about information that should be disclosed. We studied what patients want to know, as contrasted with what physicians report actually disclosing, in a population of...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198107000-00003
更新日期:1981-07-01 00:00:00
abstract::Patterns of primary health care utilization for a random sample of urban elementary school children in three ethnic groups are described. Visit type, reasons for visit, and frequency of visits remained stable from year to year. More than 50 per cent of the children were non-visitors each year; 72 per cent of those not...
journal_title:Medical care
pub_type: 杂志文章
doi:10.1097/00005650-198106000-00003
更新日期:1981-06-01 00:00:00