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BACKGROUND There are few reports describing the combined influence of the race and sex of a patient on the use of reperfusion therapy for acute myocardial infarction. METHODS To determine the relation of race and sex to the receipt of reperfusion therapy for myocardial infarction in the United States, we reviewed the medical records of 234,769 Medicare(More)
CONTEXT Recent hospital reductions in registered nurses (RNs) for hospital care raise concerns about patient outcomes. OBJECTIVE Assess the association of nurse staffing with in-hospital mortality for patients with acute myocardial infarction (AMI). DESIGN, SETTING, AND PATIENTS Medical record review data from the 1994-1995 Cooperative Cardiovascular(More)
CONTEXT Performance feedback and benchmarking, common tools for health care improvement, are rarely studied in randomized trials. Achievable Benchmarks of Care (ABCs) are standards of excellence attained by top performers in a peer group and are easily and reproducibly calculated from existing performance data. OBJECTIVE To evaluate the effectiveness of(More)
CONTEXT Issues of cost and quality are gaining importance in the delivery of medical care, and whether quality of care is better in teaching vs nonteaching hospitals is an essential question in this current national debate. OBJECTIVE To examine the association of hospital teaching status with quality of care and mortality for fee-for-service Medicare(More)
OBJECTIVE To evaluate patient and physician factors associated with prevention of glucocorticoid-induced osteoporosis and to describe temporal trends in screening and prevention of glucocorticoid-induced osteoporosis. METHODS Using databases from a national managed care organization, enrollees who had been prescribed glucocorticoids (taken for at least 60(More)
Benchmarking is generally considered to be an important tool for quality improvement. Traditional approaches to benchmarking have relied on subjective identification of 'leaders in the field'. We derive an objective, reproducible and attainable Achievable Benchmark of Care (ABC) by measuring and analysing performance on process-of-care indicators. Three(More)
BACKGROUND This study examined trends in the numbers of double contrast barium enemas, flexible sigmoidoscopies, and colonoscopies and trends in the choices of colorectal cancer screening service providers. METHODS Descriptive statistics were used to examine Medicare and Tricare data for the years 1999 to 2001. RESULTS The total volume of procedures(More)
BACKGROUND Many patients suffering acute myocardial infarction (AMI) are transferred from one hospital to another during their hospitalization. There is little information about the outcomes related to interhospital transfer. The purpose of this study was to compare processes and outcomes of AMI care among patients undergoing interhospital transfer with(More)
Webster's Dictionary defines a benchmark as 'something that serves as a standard by which others can be measured'. Benchmarking pervades the health care quality improvement literature, and benchmarks are usually based on subjective assessment rather than on measurements derived from data. As such, benchmarks may fail to yield an achievable level of(More)