Takahiro Higashi, MD, PhD; Paul G. Shekelle, MD, PhD; John L. Adams, PhD; Caren J. Kamberg, MSPH; Carol P. Roth, RN, MPH; David H. Solomon, MD; David B. Reuben, MD; Lillian Chiang, MD; Catherine H. MacLean, MD, PhD; John T. Chang, MD, MPH; Roy T. Young, MD; Debra M. Saliba, MD, MPH; Neil S. Wenger, MD, MPH
Acknowledgments: The authors thank Robert Brook, MD, ScD, for inspiration and guidance; Robin P. Hertz, PhD, senior director of outcomes research and population studies at Pfizer Inc, for providing valuable support; and Patricia Smith and Victor Gonzalez for their technical assistance.
Grant Support: Supported by a contract from Pfizer Inc. Dr. Higashi is supported by a St. Luke's Life Science Institute Fellowship Award. Dr. Shekelle was a Senior Research Associate of the Veterans Affairs Health Services Research & Development Service. Dr. Chiang is supported by a Bureau of Health Professionals Geriatrics Research Faculty Training Program. Drs. MacLean and Saliba are Research Associates of the Veterans Affairs Health Services Research & Development Service. Dr. Chang is supported by a National Research Service Award (PE-19001) and the University of California, Los Angeles, Specialty Training and Advanced Research (STAR) Program.
Potential Financial Conflicts of Interest: Stock ownership or options (other than mutual funds): R.T. Young (Pfizer Inc).
Requests for Single Reprints: Neil S. Wenger, MD, MPH, RAND, 1700 Main Street, Santa Monica, CA 90407.
Current Author Addresses: Dr. Higashi: Department of Epidemiology and Healthcare Research, Kyoto University, Yoshida-konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan.
Dr. Chang: Division of General Internal Medicine, University of California, Los Angeles, 911 Broxton Plaza, Los Angeles, CA 90095-1736.
Drs. Shekelle, MacLean, and Saliba: Greater Los Angeles Veterans Affairs Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073.
Drs. Solomon, Adams, and Wenger and Ms. Roth: RAND, 1700 Main Street, M-26, Santa Monica, CA 90407-2138.
Ms. Kamberg: RAND, 1200 South Hayes Street, Arlington, VA 22202.
Dr. Young: Division of General Internal Medicine, University of California, Los Angeles, 200 Medical Plaza, Los Angeles, CA 90095-1736.
Drs. Reuben and Chiang: Division of Geriatrics, University of California, Los Angeles, 200 Medical Plaza, Los Angeles, CA 90095-1736.
Higashi T, Shekelle PG, Adams JL, Kamberg CJ, Roth CP, Solomon DH, et al. Quality of Care Is Associated with Survival in Vulnerable Older Patients. Ann Intern Med. 2005;143:274-281. doi: 10.7326/0003-4819-143-4-200508160-00008
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Published: Ann Intern Med. 2005;143(4):274-281.
Quality-of-care evaluation often focuses on how often patients receive certain tests or treatments. Theoretically, the content of care should predict patient survival, but the evidence is inconclusive.
This study used 207 criteria to assess good care in 372 vulnerable elderly patients. When care did not meet these standards, patients were more likely to die during the 3 years of follow-up.
In vulnerable older patients, the content of care is associated with mortality. This finding supports the use of process measures in the evaluation of quality of care and shows that good care may prolong life.
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Geriatric Medicine, Healthcare Delivery and Policy.
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