Mark A Nyman
Mayo Clinic College of Medicine, USA
Title: Inclusion of short-term care patients affects the perceived performance of specialists: A retrospective cohort study
Biography
Biography: Mark A Nyman
Abstract
Background: Current publicly reported quality performance measures directly compare primary care to specialty care. Specialists see short-term patients referred due to poor control of their disease who then return to their local provider. Our study looked to determine if outcomes measured in short-term care patients differed from those in long-term care patients and what impact those differences may have on quality performance profiles for specialists.
Methods: Retrospective cohort from a large academic medical Center. Performance was measured as “Optimal Care” - all or none attainment of goals. Patients with short-term care (90 days contact) were evaluated for both specialty and primary care practices during the year 2008.
Results: Patients with short-term care had significantly lower “Optimal Care”: 7.2% vs. 19.7% for optimal diabetes care in endocrinology and 41.3% vs. 53.1% for optimal ischemic vascular disease care in cardiology (p < 0.001). Combining short and long term care patients lowered overall perceived performance in the specialty practice.
Conclusions: Factors other than quality affect the perceived performance of the specialty practice. Extending current primary care quality measurement to short-term specialty care patients without adjustment produces misleading results.