Quality of care seen improving

Researchers say greater use of evidence-based guidelines is needed.

By Damon Adams — Posted Aug. 8, 2005

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

The quality of medical care has improved slightly, but a gap still exists between care provided and evidence-based guidelines, according to a new study.

Researchers examined data on 23 quality indicators from 1992 and 2002 to gauge overall performance and racial and ethnic disparities in U.S. outpatient care. Significant improvements were found in only six of the 23 indicators studied, prompting researchers to say greater use of evidence-based medicine is needed.

"We really did not find much improvement. The gap remains wide between the best possible care and actual care of what patients receive," said Jun Ma, MD, PhD, research associate with California's Stanford University School of Medicine and lead author of the study published in the June 27 Archives of Internal Medicine.

But the federal Agency for Healthcare Research and Quality disputes that conclusion.

"We're finding that quality health care is improving across measures," said Dwight McNeill, PhD, an expert in quality improvement.

Dr. Ma and another researcher used data from two national surveys of outpatient care to measure overall performance and racial/ethnic disparities in physician offices and hospital outpatient departments in 1992 and 2002. Quality indicator performance was defined as the percentage of visits receiving appropriate care.

Changes were modest overall. Significant improvements were seen in treatment of depression, statin use for hyperlipidemia, inhaled corticosteroid use for asthma, avoiding routine urinalysis and avoiding inappropriate medications in the elderly.

Of the 23 indicators, only two showed statistical differences by race. Blacks were more likely than whites to receive ACE inhibitors to treat congestive heart failure. Whites were less likely to receive unnecessary antibiotics to treat common colds.

Dr. Ma said the finding does not mean racial and ethnic disparities do not exist. Dr. McNeill agreed. "We find that disparities are still pervasive," he said.

Some medical organizations are promoting quality improvements in physician practices. The AMA-led Physician Consortium for Performance Improvement has developed performance measure sets that primary care physicians can use.

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn