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Improving Patient Care |

The Quality of Medical Care Provided to Vulnerable Community-Dwelling Older Patients

Neil S. Wenger, MD, MPH; David H. Solomon, MD; Carol P. Roth, RN, MPH; Catherine H. MacLean, MD, PhD; Debra Saliba, MD; Caren J. Kamberg, MSPH; Laurence Z. Rubenstein, MD, MPH; Roy T. Young, MD; Elizabeth M. Sloss, PhD; Rachel Louie, MS; John Adams, PhD; John T. Chang, MD, MPH; Patricia J. Venus, MA; John F. Schnelle, PhD; and Paul G. Shekelle, MD, PhD
[+] Article and Author Information

From RAND Health, Santa Monica, California, and Washington, DC; University of California, Los Angeles, School of Medicine, the Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles Jewish Home for the Aging, and Borun Center for Gerontological Research, Los Angeles, California; and the Center for Health Care Policy & Evaluation, United Healthcare Corp., Minnetonka, Minnesota.


Acknowledgments: The authors thank Robert Brook, MD, ScD, for initiating this project and for providing inspiration and guidance throughout the work. Robin P. Hertz, PhD, senior director of outcomes research/population studies at Pfizer Inc, provided valuable support. They also recognize the expert assistance of Dr. Ralph Levinson, who provided ophthalmologic chart review, and the technical assistance of Patricia Smith.

Grant Support: By a grant from Pfizer Inc to RAND.

Potential Financial Conflicts of Interest:Stock ownership or options (other than mutual funds): D.H. Solomon, R.T. Young, R. Louie (Pfizer Inc).

Requests for Single Reprints: Neil S. Wenger, MD, RAND, 1700 Main Street, M-26, Santa Monica, CA 90407-2138; e-mail, nwenger@mednet.ucla.edu.

Current Author Addresses: Drs. Wenger, Solomon, MacLean, Saliba, and Adams; Ms. Roth; and Ms. Louie: RAND, 1700 Main Street, M-26, Santa Monica, CA 90407-2138.

Ms. Kamberg and Dr. Sloss: RAND, 1200 South Hayes Street, Arlington, VA 22202.

Dr. Rubenstein: Geriatric Research Education and Clinical Center, Sepulveda Veterans Affairs Medical Center, 16111 Plummer Street, 11E, Sepulveda, CA 91343.

Dr. Young: Division of General Internal Medicine, University of California, Los Angeles, 200 Medical Plaza, Los Angeles, CA 90095-1736.

Dr. Chang: Division of General Internal Medicine, University of California, Los Angeles, 911 Broxton Plaza, Los Angeles, CA 90095-1736.

Ms. Venus: Center for Health Care Policy and Evaluation, 12125 Technology Drive, MN002-0260, Minneapolis, MN 55344.

Dr. Schnelle: University of California, Los Angeles, 7150 Tampa Avenue, Reseda, CA 91335.

Dr. Shekelle: Greater Los Angeles Veterans Affairs Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073.

Author Contributions: Conception and design: N.S. Wenger, D.H. Solomon, C.P. Roth, C.H. MacLean, D. Saliba, L.Z. Rubenstein, R.T. Young, E.M. Sloss, J.T. Chang, J.F. Schnelle, P.G. Shekelle.

Analysis and interpretation of the data: N.S. Wenger, D.H. Solomon, C.P. Roth, C.H. MacLean, D. Saliba, L.Z. Rubenstein, R.T. Young, R. Louie, J. Adams, J.T. Chang, P.G. Shekelle.

Drafting of the article: N.S. Wenger, J.T. Chang.

Critical revision of the article for important intellectual content: N.S. Wenger, D.H. Solomon, C.H. MacLean, D. Saliba, C.J. Kamberg, L.Z. Rubenstein, E.M. Sloss, R. Louie, J.T. Chang, P.G. Shekelle.

Final approval of the article: N.S. Wenger, D.H. Solomon, C.P. Roth, C.H. MacLean, D. Saliba, C.J. Kamberg, L.Z. Rubenstein, E.M. Sloss, R. Louie, J.T. Chang, J.F. Schnelle, P.G. Shekelle.

Provision of study materials or patients: C.P. Roth, P.J. Venus.

Statistical expertise: J. Adams.

Administrative, technical, or logistic support: C.P. Roth, C.J. Kamberg, E.M. Sloss, J.T. Chang.

Collection and assembly of data: D.H. Solomon, C.P. Roth, C.J. Kamberg, R.T. Young, R. Louie, J.T. Chang, P.J. Venus, P.G. Shekelle.


Ann Intern Med. 2003;139(9):740-747. doi:10.7326/0003-4819-139-9-200311040-00008
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The Assessing Care of Vulnerable Elders (ACOVE) project developed and applied a quality assessment system for vulnerable older persons. The assessment system aimed to develop quality indicators (QIs) that cover the spectrum of care for these patients. Indicators were implemented by using medical record abstraction and patient interview.

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Summary for Patients

Quality of Medical Care for Patients Older Than Age 65 Years

The summary below is from the full report titled “The Quality of Medical Care Provided to Vulnerable Community-Dwelling Older Patients.” It is in the 4 November 2003 issue of Annals of Internal Medicine (volume 139, pages 740-747). The authors are N.S. Wenger, D.H. Solomon, C.P. Roth, C.H. MacLean, D. Saliba, C.J. Kamberg, L.Z. Rubenstein, R.T. Young, E.M. Sloss, R. Louie, J. Adams, J.T. Chang, P.J. Venus, J.F. Schnelle, and P.G. Shekelle.

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