Most Important Outcomes Research Papers on Variation in Cardiovascular Disease
| Autor: | Aakriti Gupta, Vivek T. Kulkarni, Purav Mody, Behnood Bikdeli, Ruijun Chen, Kumar Dharmarajan, Julianna F. Lampropulos |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Referral medicine.medical_treatment Disease Risk Assessment Residence Characteristics Risk Factors Health care medicine Humans Healthcare Disparities Practice Patterns Physicians' Intensive care medicine Quality Indicators Health Care business.industry Age Factors Health services research Percutaneous coronary intervention Outcome and Process Assessment Health Care Treatment Outcome Cardiovascular Diseases Practice Guidelines as Topic Guideline Adherence Health Services Research Outcomes research Cardiology and Cardiovascular Medicine business Risk assessment Medicaid |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 6 |
| ISSN: | 1941-7705 1941-7713 |
| Popis: | The topic of variation in health care has garnered significant attention since Wennberg and Gittelsohn in 19731 identified up to 10-fold variation in use of tonsillectomy and other surgical procedures in small towns within Maine and Vermont. Wennberg and others further described large differences in the propensity to hospitalize patients in Boston and New Haven that were unrelated to case-fatality but highly related to bed supply.2 These findings suggested that regional treatment variation is in part driven by differences in physician preferences and heath resource capacity rather than the health status of patients. These observations of extensive geographic variation in treatment were most extensively formalized in the Dartmouth Atlas of Health Care, a massive undertaking that used Medicare claims data to describe differences in cost and utilization across more than 300 hospital referral regions (HRRs) that were built from zip codes and hospital service areas. The Dartmouth Atlas has been published by Wennberg and colleagues since 1996. More recently, greater attention has been directed to variation in treatment and outcomes at the hospital level. Health care payers including the Centers for Medicare and Medicaid Services have motivated the creation of performance measures that describe hospital variation in longitudinal outcomes such as rehospitalization and death.3–7 These measures have been endorsed by the National Quality Forum and are currently being used to direct financial penalties to hospitals with higher-than-expected rates of adverse outcomes for common conditions such as heart failure, acute myocardial infarction, and pneumonia. In the future, Medicare will likely assess hospital variation in outcomes for specific cardiovascular treatments including percutaneous coronary intervention and percutaneous valve replacement. Given the increased focus on treatment and outcomes variation at both regional and hospital levels, we have dedicated the reviews in this issue of Circulation: Cardiovascular Quality and Outcomes … |
| Databáze: | OpenAIRE |
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