Missed Opportunities in the Primary Care Management of Early Acute Ischemic Heart Disease

Sequist, Thomas D.; Marshall, Richard; Lampert, Steven; Buechler, Elizabeth J.; Lee, Thomas H.

doi:10.1001/archinte.166.20.2237

Cited by 34 publications

(30 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The HVMA electronic record system assigns a unique primary care physician to each patient, and data from this medical record system have been used extensively in formal analyses of quality of care. [18][19][20][21][22] We supplemented electronic medical record system data with claims data to assess colorectal cancer screening and diabetic eye exams, as these services are sometimes received outside of the HVMA network. We applied HEDIS criteria to identify appropriate denominator and numerator populations using diagnostic and billing codes within the electronic medical record during 2005.…”

Section: Individual Physician Datamentioning

confidence: 99%

Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes

et al. 2008

Self Cite

View full text Add to dashboard Cite

BACKGROUND: Physicians are increasingly asked to improve the delivery of clinical services and patient experiences of care. OBJECTIVE:We evaluated the association between clinical performance and patient experiences in a statewide sample of physician practice sites and a sample of physicians within a large physician group. DESIGN, SETTING, PARTICIPANTS:We separately identified 373 practice sites and 119 individual primary care physicians in Massachusetts. MEASUREMENTS: Using Health Plan Employer Dataand Information Set data, we produced two composites addressing processes of care (prevention, disease management) and one composite addressing outcomes. Using Ambulatory Care Experiences Survey data, we produced seven composite measures summarizing the quality of clinical interactions and organizational features of care. For each sample (practice site and individual physician), we calculated adjusted Spearman correlation coefficients to assess the relationship between the composites summarizing patient experiences of care and those summarizing clinical performance.RESULTS: Among 42 possible correlations (21 correlations involving practice sites and 21 involving individual physicians), the majority were positive in site level (71%) and physician level (67%) analyses. For the 28 possible correlations involving patient experiences and clinical process composites, 8 (29%) were significant and positive, and only 2 (7%) were significant and negative. The magnitude of the significant positive correlations ranged from 0.13 to 0.19 at the site level and from 0.28 to 0.51 at the physician level. There were no significant correlations between patient experiences and the clinical outcome composite. CONCLUSIONS:The modest correlations suggest that clinical quality and patient experience are distinct, but related domains that may require separate measurement and improvement initiatives.KEY WORDS: quality of care; patient centered care; primary care; quality measurement; quality improvement.

show abstract

Section: Individual Physician Datamentioning

confidence: 99%

Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes

et al. 2008

Self Cite

View full text Add to dashboard Cite

show abstract

“…[27][28][29][30][31] We used automated data extracts to identify 1041 positive six-specimen FOBTs obtained from 1009 unique patients over 18 years of age between 01/ 01/2004 and 12/31/2006. The study authors (SKR, TS, TDS) performed chart reviews to identify the reason for ordering the FOBT, history of colonoscopy, proposed treatment plans (including endoscopic procedures, gastroenterology consultation prior to colonoscopy, or repeat FOBT), and eventual treatments and clinical findings.…”

Section: Data Collectionmentioning

confidence: 99%

Challenges in the Management of Positive Fecal Occult Blood Tests

2009

Self Cite

View full text Add to dashboard Cite

“…1,2 This challenge is highlighted in the primary care office, where one-quarter of all chest pain evaluations take place, 3 and where important gaps in the quality and safety of chest pain evaluations exist. 4,5 There is an extensive literature to guide the evaluation of chest pain in the emergency department; 1,2 however, the optimal primary care approach may be fundamentally different. Primary care offices have limited capability to perform serial cardiac enzymes or immediate exercise stress testing as is done in the emergency department, 6 and the patients are relatively low risk for cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

Electronic Risk Alerts to Improve Primary Care Management of Chest Pain: A Randomized, Controlled Trial

et al. 2011

Self Cite

View full text Add to dashboard Cite

Missed Opportunities in the Primary Care Management of Early Acute Ischemic Heart Disease

Abstract: Primary care clinicians play an important role in the management of acute cardiac ischemia. The Framingham risk score can help identify missed opportunities that warrant more intensive evaluation.

Cited by 34 publications

References 34 publications

Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes

Quality Monitoring of Physicians: Linking Patients’ Experiences of Care to Clinical Quality and Outcomes

Challenges in the Management of Positive Fecal Occult Blood Tests

Electronic Risk Alerts to Improve Primary Care Management of Chest Pain: A Randomized, Controlled Trial

Contact Info

Product

Resources

About