The American journal of managed care
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To refine a previously published standardized quality and utilization measurement set for migraine care and to establish performance benchmarks. ⋯ This study demonstrates the value of standardized measures in identifying potential quality issues for migraine care, including underdiagnosis, overutilization of imaging, and underutilization of preventive drugs.
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To examine the association between preventable hospitalization rates and proportions of managed care enrollment at the primary care service area level. ⋯ Despite increased managed care enrollment, the role of Medicare managed care in explaining declines in preventable hospitalization rates diminished over time. The results could be explained by the growth of private fee-for-service types of managed care plans and the resultant decline in emphasis on care coordination relative to health maintenance organization plans.
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Recent research suggests that second generation antipsychotics (SGAs) may be used more often than clinically warranted. An intervention consisting of academic detailing and a prescriber survey was employed to encourage the reduction of newly prescribed on-patent SGAs. ⋯ Academic detailing coupled with a provider survey did not decrease the rate of new prescriptions for on-patent SGAs. Reasons for prescribing SGAs were not consistent with recent research findings regarding efficacy and side effects.
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Over the past 2 decades, numerous studies have demonstrated the existence of racial disparities in patient care in the United States. Specifically, African Americans with diabetes are less likely to have recommended process of care measures performed and outcome benchmarks for quality of care. ⋯ African American patients with diabetes were as likely or more likely to have recommended process of care measures performed. In spite of this, intermediate diabetes outcomes were still poorer in the same African American population.