title: Quality-of-care assessment by process and outcome scoring. Use of weighted algorithmic assessment criteria for evaluation of emergency room care of women with symptoms of urinary tract infection.
abstract: Weighted process criteria based on chart review using an algorithmic method, and weighted outcome criteria based on a telephone interview with the patient, were used to assess the quality of emergency room care of women with symptoms of acute urinary tract infection. Outcomes at a municipal hospital were significantly better than those at an affiliated voluntary hospital. Process and outcome scores were positively correlated at both hospitals; the data suggest, but do not themselves adequately test, the hypothesis that the correlation is curvilinear and that there is a threshold process score below which a poor outcome is extremely likely. Our findings suggest that weighted algorithmic assessment criteria are a useful method for quality assessment and are consistent with the testable hypothesis that the greatest improvements in outcome may result from raising the quality of care from a poor to an adequate level rather than from an adequate to an optimal level.
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003657:Decision Making; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D008433:Mathematics; D009518:New York; D011787:Quality of Health Care; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents