Authors: Yurk R, Jenckes MW, Stuart ME, Shaffer T, et al.
Title: Benchmarking Applications Linking State Strategic Planning, Quality Improvement, and Consumer Reporting.
Publication: Journal of Public Health Management Practice 7(3):47-58.
Date: 2001
Abstract: This article demonstrates the value of using benchmark patient satisfaction data for Medicaid program quality improvement. The authors compare surveys of Maryland Medicaid and Federal employees in Maryland utilizing the latter as an external benchmark. Unadjusted and adjusted analyses found a significantly lower percentage of Medicaid than Federal employees rated telephone access excellent, very good or good, whereas more Medicaid respondents rated advice on prevention and choice of primary care doctor highly. Patient satisfaction external benchmark data provide managed care organizations (MCOs) and State policymakers with goals to improve quality and standards to measure care objectively in vulnerable populations.
Topics: Managed Care
Authors: McNamara R, Powe N, Thiemann D, Shaffer T, et al.
Title: Specialty of Principal Care Physician and Medicare Expenditures in Patients with Coronary Artery Disease: Impact of Comorbidity and Severity.
Publication: American Journal of Managed Care 7:261-66.
Date: 2001
Abstract: To explore differences in expenditures for elderly patients with acute and chronic coronary artery disease according to the specialty of the principal care physician, a total of 250,514 patients with coronary artery disease (ICD-9 codes 410-414) were drawn from a national 5 percent random sample of 1992 Medicare beneficiaries. Patients were classified by the physician type with the highest number of Medicare Part B outpatient claims into a cardiologist group and a generalist group. The outcome was mean total expenditures, stratifying (1) by comorbidity as measured by the modified Charlson Index and (2) by severity defined as the proportion of patients with acute myocardial infarction or unstable angina. Those patients in the cardiologist group had lower comorbidity and higher severity than those in the generalist group. Overall mean expenditures were significantly higher for the cardiologist group than for the generalist group ($7,658 vs $6,047; P < .001). These differences in mean expenditures were evident at each level of comorbidity. However, when stratified by severity of diagnosis, differences were seen pre-dominantly in those, with acute diagnoses. Expenditures were higher when cardiologists were the principal care physicians treating patients with acute disease ($15,378 vs $12,260; P < .001) compared with chronic disease where the expenditures were similar ($4,856 vs $4,745; P = .53).
Topics: Medicare, Chronic Conditions.