Clinical Measures
Clinical measures can be used to assess quality of care and patient
satisfaction. Examples are provided here of measures that can be
used to assess care quality for three of the most common conditions:
diabetes, heart disease, and cancer.
Diabetes
More than 6 percent of all
Americans have diabetes. Diabetes
is the leading cause of blindness,
leg amputation not resulting from
trauma, and kidney disease. Diabetes increases the risk of
complications in pregnant women,
and it is a risk factor for heart
disease and stroke. People who
have diabetes are two to four times
as likely to die from heart disease
or stroke as those without diabetes.
The following five measures can
be used to assess quality of care
for diabetes. If you have diabetes,
you should receive the following
tests and exams:
- Regular hemoglobin A1c (blood glucose) testing.
- Regular cholesterol testing.
- Annual retinal eye exam.
- Annual foot exam.
- Flu shot each year.
Heart Disease
Heart disease—or cardiovascular
disease—is a collection of
diseases of the heart and blood
vessels that includes heart attack,
stroke, and heart failure. About 64
million Americans are living with
heart disease.
Heart disease is the number one
cause of death in the United
States. Maintaining control of
blood pressure and cholesterol
can help you prevent heart attack
and stroke.
The following are examples of
measures that can be used to
assess care for heart disease.
For adults age 18 and older:
- Blood pressure measurement.
- Cholesterol testing.
In general:
- If you smoke, being advised to stop smoking.
- If you suffer a heart attack, receiving aspirin within 24 hours of hospital admission and being prescribed beta-blocker therapy at hospital discharge.
John's Story
John awoke from a restless night's
sleep with a feeling of tightness
in his chest and pain down his left
arm. John was having a heart
attack. His wife called 911, and
he was taken to the emergency
room via ambulance.
The ER doctors took very good
care of John. He was given an
aspirin almost as soon as he
arrived at the hospital.
Fortunately, John's heart attack
was mild. After undergoing some
special tests, his heart surgeon
implanted a stent to prop open his
partially clogged artery.
As John was being discharged
from the hospital, his doctor
prescribed beta-blocker therapy to
reduce the risk that he would
have another heart attack. John
was advised to have his blood
pressure and cholesterol checked
regularly. John got the right care
for his heart attack.
More than 60 million men and
women are living with heart
disease. Everyone should know
what constitutes good quality care
for heart disease.
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Cancer
Cancer is the Nation's second leading cause of death, after heart
disease. Each year, more than 1 million new cases of cancer are
diagnosed. Four cancers account for over half of the new cases
reported each year. The four
cancers are: lung, colorectal,
breast, and prostate.
Screening to permit early
detection holds the most
promise for successful cancer
treatment.
Talk to your doctor about
screening tests for all of these
cancers, especially if other
members of your family have
had these cancers or if you
smoke.
The following are examples of
quality measures for several
types of cancer screening.
Breast and cervical cancer:
- Mammography exam for women age 40 and older.
- Pap smear testing for women age 18 and older.
Colorectal cancer: Men and
women age 50 and older should
receive the following tests:
- Fecal occult blood testing (a test to detect blood in the stool).
- Flexible sigmoidoscopy/colonoscopy exam. Check with your doctor about how often you should have this screening.
Jean's Story
Jean was 45 when she went to her
doctor for a checkup 5 years ago.
Her doctor performed a clinical
breast exam and found nothing
remarkable. Jean was given a
referral to a nearby x-ray facility
to have a mammogram.
A week or so later, Jean received
a phone call from her doctor's
office asking her to come in to go
over the results. The
mammogram showed a small
lump in Jean's right breast. Her
doctor referred her to a breast
surgeon for a biopsy. The biopsy
revealed early-stage breast cancer.
Jean had a lumpectomy and
followup radiation.
Today, Jean is cancer-free and
looking forward to the birth of
her first grandchild. Getting the
right care—a mammogram—at the
right time—over 40 years of
age—saved Jean's life. For Jean,
getting quality health care gave
her a new lease on life.
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