A collaborative initiative to improve the care of elderly Medicare patients with hypertension.
Qualidigm, the Connecticut Quality Improvement Organization (QIO), collaborated with 17 primary care physicians (PCPs) in private practice to improve the care of elderly patients with hypertension. Patients were identified from Medicare billing data and care was assessed from medical records. Improvement interventions included feedback of baseline performance data and provision of a variety of practice enhancing materials. Care was assessed for 590 patients in 1997 (16-47 patients/PCP) and 547 patients in 1999 (7-51 patients/PCP). Patient characteristics were similar in both periods. Use of recommended therapies and blood pressure control, ie, percent < 140/90 mm Hg, was low and did not improve significantly between the 2 periods (aggregate 39% in 1997 versus 42% in 1999; P = .24). Care of elderly patients with hypertension was not improved with a multifaceted QIO intervention. Additional study is required to determine incentives, barriers, and facilitating factors for quality improvement in the private practice primary care setting.
Meehan
Thomas P
TP
Qualidigm, 100 Roscommon Drive, Middletown, CT 06457, USA. tmeehan@ctqio.sdps.org
Tate
Janet P
JP
Holmboe
Eric S
ES
Teeple
Elizabeth A
EA
Elwell
Anne
A
Meehan
Rachel R
RR
Petrillo
Marcia K
MK
Huot
Stephen J
SJ
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D006278:Medicare; D005791:Patient Care / Q000379:methods; D011320:Primary Health Care / Q000379:methods*; D011331:Private Practice / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration*