Clinical studyThe association between quality improvement activities performed by managed care organizations and quality of care☆
Section snippets
Initial selection of quality improvement activity programs
We selected quality improvement activities for organizations receiving an accreditation status of “excellent”, “commendable”, or “accredited” from the National Committee for Quality Assurance. An “excellent” or “commendable” status indicates that the organization met all the accreditation requirements for consumer protection and quality improvements and has standard quality measure scores in the highest range of national performance. An “accredited” status is given to organizations that meet
Results
Of 399 quality improvement activities evaluated, 79 (19.8%) had at least one measure that could be matched to a corresponding effectiveness-of-care category score for the same managed care organization during the same time period (Appendix 3 at www.zynx.com/research/ncqa_appendices.htm depicts the flow of identifying the quality improvement activities). All quality improvement activities were implemented at least 22 months (median, 36 months) before measurement of the performance score.
Discussion
Improving the quality of health care in the United States is challenging. The effectiveness of potential solutions, such as quality improvement programs initiated by managed care organizations, may vary widely. We hypothesized that a formal quality improvement activity should lead to demonstrable differences in objective quality measures. Thus, organizations with activities targeted at improving rates of mammography screening should, on average, have better rates than organizations without such
Acknowledgements
We thank L. Gregory Pawlson, MD, MPH, and Sarah Shih, MPH, from the National Committee for Quality Assurance, Washington, D.C., for their important contributions to this project.
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Practice guidelines and prediction rules should be subject to careful clinical testing
JAMA
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This investigator-initiated work was partially supported by a research grant from TAP Pharmaceutical Products, Inc., Lake Forest, Illinois.