221
views
0
recommends
+1 Recommend
0 collections
    8
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      The Quality of Health Care Delivered to Adults in the United States

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          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 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. 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. Copyright 2003 Massachusetts Medical Society

          Related collections

          Author and article information

          Journal
          New England Journal of Medicine
          N Engl J Med
          Massachusetts Medical Society
          0028-4793
          1533-4406
          June 26 2003
          June 26 2003
          : 348
          : 26
          : 2635-2645
          Article
          10.1056/NEJMsa022615
          12826639
          bb42543f-28aa-4b83-8d90-506f508873cf
          © 2003
          History

          Comments

          Comment on this article