Medical care
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The provision of preventive services and continuity of care are important aspects of long-term care (LTC). A proposed quality indicator of such care is the rate of hospitalizations due to ambulatory care sensitive conditions (ACSCs). As the ACSC approach to identifying potentially avoidable hospitalizations (PAH) was developed for younger community-dwelling adults in the United States, we sought to examine its applicability as a quality indicator for older institutionalized residents in Canada. ⋯ Changes to the original list of ACSCs led to more hospitalizations being categorized as potentially avoidable. Significant variation between LTC facilities and over time in our PAH indicator may identify areas for improvement in preventive services and continuity of care for LTC residents.
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Patient-provider communication is essential for high-quality asthma care. The objective of this study was to assess the potential relationship of language barriers with outcomes of inner-city asthmatics. ⋯ Inner-city asthmatics with limited English proficiency have significantly poorer asthma control, higher rates of resource utilization, and a lower quality of life. Further research is necessary to understand the mechanisms underlying this association.
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Individual quality measures have significant limitations for assessing surgical performance. Despite growing interest in composite measures, empirically-based methods for combining multiple domains of surgical quality are not well established. ⋯ Compared with individual surgical quality indicators, empirically derived composite measures are superior in explaining variation in hospital mortality rates and in forecasting future performance. Such measures could be useful for public reporting, value-based purchasing, or benchmarking for quality improvement purposes.
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Editorial Comment
Who you are and where you live: race and the geography of healthcare.
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Comparative Study
Comparison of population health status in six european countries: results of a representative survey using the EQ-5D questionnaire.
The EQ-5D questionnaire is an instrument for describing and valuing health states. ⋯ Self-reported EQ-5D health status differed considerably between countries, calling for caution when making international comparisons of disease burden and health care effectiveness.