Medical care
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Multicenter Study
Is there an association between quality of in-hospital cardiac care and proportion of low-income patients?
Process measures have been developed and implemented to evaluate the quality of care patients receive in the hospital. This study examines whether there is an association between the quality of in-hospital cardiac care and a hospital's proportion of low-income patients. ⋯ Hospital adherence to QoC process measures for AMI and CHF patients declined as the proportion of low-income patients increased. Future research is needed to examine the role of community characteristics and market forces on the ability of hospitals with a disproportionate share of low-income patients to maintain the staffing, equipment, and policies necessary to provide the recommended standards of care for AMI and CHF patients.
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Comparative Study
Geographic area variations in the Medicare health plan era.
Prior research identified variations in care experiences across Medicare health plans (Medicare Advantage [MA]), but the relative amount of variation in MA and traditional fee-for-service (FFS) Medicare is unknown. ⋯ Relative performance between MA and FFS may differ across areas and locally between individual plans and FFS. Quality improvement initiatives should address local system factors that affect both MA and FFS, and identify organizational factors that make some MA plans more successful in improving quality.