Evaluating Medicare's Quality Improvement Organizations

评估医疗保险的质量改进组织

• 批准号: 6801697
• 负责人: Claire F Snyder
• 金额: $ 3.18万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2005-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6801697
• 关键词: Medicare /Medicaid; geographic difference; health care quality; health care service evaluation; health care service organization; health economics; health services research tag; hospital analysis; hospital equipment /supply; hospital patient care; human data; teaching

DESCRIPTION (provided by the applicant): The objective is to explore whether hospital participation with Medicare's Quality Improvement Organizations (QIOs) leads to better quality of care for Medicare beneficiaries. The QIO program is the largest federal initiative to improve the quality of care, and Medicare spends $200 million per year on the program. From the inception of Medicare, the federal government has been concerned about the quality of care provided to beneficiaries. Currently, Medicare contracts with QIOs to improve the quality of care. The QIOs collaborate with hospitals who participate on a voluntary basis. The QIOs' impact is measured using process indicators associated with clinical benefit. The proposed study is a retrospective pre-post controlled study that will compare the quality of care received by patients in hospitals that actively participate with the QIOs to the quality of care received by patients in hospitals that do not participate with the QIOs. The Delmarva and IPRO QIOs, which have responsibility for Maryland, the District of Columbia, and New York, have agreed to provide their data for this analysis. Approximately 50% of hospitals in these states participated with their QIOs to improve the quality of care. Quality will be assessed using 18 process indicators in 4 clinical areas (acute myocardial infarction, heart failure, stroke, pneumonia) in the inpatient setting. Baseline quality will be assessed using process indicator data collected in 1998-1999 from approximately 3500 medical records for each clinical area. Follow-up quality will be assessed on the same process indicators using data collected in 2000-2001, also from approximately 3500 medical records per clinical area. The hypothesis is that there will be a statistically significant (p<.05) difference in the increase in the proportion of patients receiving the quality processes in hospitals participating with the QIOs during the study period compared to the increase in proportion of patients in hospitals that did not participate. The analysis will control for hospital characteristics (bedsize, urban/rural status, for-profit/not-for-profit status, and teaching status) and patient characteristics (age, race, sex). This study is believed to be the first evaluation of the QIOs in multiple clinical areas using a control group. It evaluates an important government quality improvement effort and addresses the elderly, an Agency for Healthcare Research and Quality priority population.

描述（由申请人提供）：目的是探讨医院参与 Medicare 质量改进组织 (QIO) 是否可以为 Medicare 受益人带来更好的护理质量。 QIO 计划是提高护理质量的最大联邦举措，Medicare 每年在该计划上花费 2 亿美元。自医疗保险诞生以来，联邦政府一直关注为受益人提供的护理质量。目前，Medicare 与 QIO 签订合同以提高护理质量。 QIO 与自愿参与的医院合作。 QIO 的影响是使用与临床效益相关的过程指标来衡量的。拟议的研究是一项回顾性前后对照研究，将比较积极参与 QIO 的医院中患者接受的护理质量与未参加 QIO 的医院中患者接受的护理质量。负责马里兰州、哥伦比亚特区和纽约州的 Delmarva 和 IPRO QIO 已同意提供用于此分析的数据。这些州大约 50% 的医院参与 QIO，以提高护理质量。将在住院环境中使用 4 个临床领域（急性心肌梗塞、心力衰竭、中风、肺炎）的 18 个过程指标来评估质量。将使用 1998-1999 年从每个临床领域约 3500 份医疗记录中收集的过程指标数据来评估基线质量。将使用 2000-2001 年收集的数据（也来自每个临床领域约 3500 份医疗记录）根据相同的过程指标评估随访质量。假设是，在研究期间参与 QIO 的医院接受质量流程的患者比例的增加与接受 QIO 的医院接受质量流程的患者比例的增加相比，存在统计显着性 (p<.05) 差异。没有参加。该分析将控制医院特征（床位大小、城市/农村状况、营利性/非营利性状况和教学状况）和患者特征（年龄、种族、性别）。这项研究被认为是首次使用对照组对多个临床领域的 QIO 进行评估。它评估了政府重要的质量改进工作，并针对老年人、医疗保健研究机构和质量优先人群。