Jun 27, 2003

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

The New England Journal of Medicine
E A McGlynnE A Kerr

Abstract

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. 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. 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 p...Continue Reading

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  • Citations2160

References

Mentioned in this Paper

Cataract
Alcoholic Intoxication, Chronic
Senile Cataract
Repeated Rounds of Survey
Protocol Compliance
Adherence (Attribute)
Prophylactic Behavior
Quality of Health Care

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