From adversary to partner: have quality improvement organizations made the transition?

Objective: To describe the perceived impact of the Centers for Medicare and Medicaid Services Quality Improvement Organizations (QIOs) on quality of care for patients hospitalized with acute myocardial infarction, in the context of new efforts to work more collaboratively with hospitals in the pursuit of quality improvement.

Data Source: Primary data collected from a national random sample of 105 hospital quality management directors interviewed between January and July 2002.

Study Design: We interviewed quality management directors concerning their interactions with the QIO interventions, the helpfulness of QIO interventions and the degree to which they helped or hindered their hospital quality efforts, and their recommendations for improving QIO effectiveness.

Long-term mortality in cerebrovascular disease.

Background And Purpose: Stroke is the third leading cause of death in the United States, yet data are limited about the temporal pattern of mortality among patients with cerebrovascular disease. The objectives of this study were to identify predictors of 6-month mortality and to evaluate 5-year mortality in patients with cerebrovascular disease.

Methods: Our population included fee-for-service Medicare beneficiaries aged > or =65 years who were discharged with an acute ischemic stroke, transient ischemic attack (TIA), or carotid stenosis (International Classification of Diseases, Ninth Revision, Clinical Modification codes 433 to 436) from Connecticut acute care hospitals in 1995.

Burden of illness score for elderly persons: risk adjustment incorporating the cumulative impact of diseases, physiologic abnormalities, and functional impairments.

Background/objectives: To develop and validate a new risk adjustment index-the Burden of Illness Score for Elderly Persons (BISEP)-which integrates multiple domains, including diseases, physiologic abnormalities, and functional impairments. RESEARCH DESIGN SUBJECTS: The index was developed in a prospective cohort of 525 patients aged > or = 70 years from the medicine service of a university hospital. The index was validated in a cohort of 1246 patients aged > or = 65 years from 27 hospitals.