دورية أكاديمية
How patients' sociodemographic characteristics affect comparisons of competing health plans in California on HEDIS quality measures.
| العنوان: | How patients' sociodemographic characteristics affect comparisons of competing health plans in California on HEDIS quality measures. |
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| المؤلفون: | Zaslavsky AM; Department of Health Care Policy, Harvard Medical School, Boston 02115, USA. zaslavsky@hcp.med.harvard.edu, Epstein AM |
| المصدر: | International journal for quality in health care : journal of the International Society for Quality in Health Care [Int J Qual Health Care] 2005 Feb; Vol. 17 (1), pp. 67-74. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 9434628 Publication Model: Print Cited Medium: Print ISSN: 1353-4505 (Print) Linking ISSN: 13534505 NLM ISO Abbreviation: Int J Qual Health Care Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Oxford : Oxford University Press Original Publication: Kidlington, Oxford, UK ; Tarrytown, NY : Pergamon, c1994- |
| مواضيع طبية MeSH: | Quality Indicators, Health Care*, Health Benefit Plans, Employee/*standards, Benchmarking ; California/epidemiology ; Catchment Area, Health ; Demography ; Economic Competition ; Ethnicity/statistics & numerical data ; Health Benefit Plans, Employee/statistics & numerical data ; Humans ; Quality Assurance, Health Care ; Socioeconomic Factors |
| مستخلص: | Objective: To estimate effects of patient sociodemographic characteristics on differential performance within and between plans in a single market area on the HEDIS quality of care measures, widely used for purchasing and accreditation decisions in the United States. Design: Using logistic regression, we modeled associations of age, sex, and zip-code-linked sociodemographic characteristics of health plan members with HEDIS measures of screening and preventive services. We calculated the impact of adjusting for these associations on measures of health plan performance. Setting: Twenty-two California health plans provided individual-level HEDIS data and zip codes of residence for up to 2 years. Participants: 110 541 commercially insured health plan members. Main Outcome Measures: Ten HEDIS quality-of-care measures. Results: Performance on quality measures was negatively associated with percent receiving public assistance in the local area (seven out of 10 measures), percent Black (three measures), and percent Hispanic (four measures), and positively associated with percent college educated (six measures), and percent urban (three measures), controlling for plan, while associations with percent Asian were positive for three measures and negative for one (P < 0.05 for six associations, P < 0.01 for four, P < 0.001 for 17). Associations were consistent across plans and over time. Adjustment for these characteristics changed rates for most plans and measures by <5 percentage points. Conclusions: Adjustment for socioeconomic case mix has little impact on the measured performance of most plans in California, but substantially affects a few. The impact of case mix on indicators should be considered when making comparisons of health plan quality. |
| معلومات مُعتمدة: | NS09473-03 United States NS NINDS NIH HHS |
| تواريخ الأحداث: | Date Created: 20050126 Date Completed: 20050624 Latest Revision: 20211203 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1093/intqhc/mzi005 |
| PMID: | 15668313 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1353-4505 |
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| DOI: | 10.1093/intqhc/mzi005 |