Provider and Hospital Characteristics Associated With Geographic Variation in the Evaluation and Management of Elderly Patients With Heart Failure

Abstract

Characteristics of providers and hospitals explain in part the geographic variation in guideline-based care for elderly patients with heart failure.

Canadian Forest Fires and the Effects of Long-Range Transboundary Air Pollution on Hospitalizations among the Elderly

“…In interpreting the findings of our analysis, considerations need to be given to the inherent limitations of the data analyzed. Information in the Medicare database is prone to bias due to inaccuracy of claims coding for specific diagnoses [80][81][82][83]. In an attempt to reduce misclassification for outcomes of interest, we used primary and secondary diagnosis codes to identify records for inclusion.…”

Geographic Variation in HMG-CoA Reductase Inhibitor Use in Dialysis Patients

“…For example, there are regional differences in Medicare spending, 1,2 quality of drug prescribing, 3 quality of clinical management during hospitalization, 4 use of surgical procedures, 5 and adherence to medication guidelines for use of drugs like HMG-CoA reductase inhibitors. 6 Geographic variation in care is also marked in the kidney disease population, in whom substantial geographic variation in care has been demonstrated for pre-dialysis access to a nephrologist, 7 vascular access creation, 7 and selection of peritoneal dialysis as a modality of renal replacement therapy.…”

Linking Joint Commission Inpatient Core Measures and National Patient Safety Goals with Evidence

“…Despite widespread dissemination of the core measures, safety goals, and related quality guidelines, there is significant variation in their application across hospitals (8)(9)(10)(11)(12)(13). Reasons for this variance are complex and may include differences in guideline familiarity, provider training, and tools and systems to ensure that recommended care is provided and documented (8).…”