Primaris Press Release
| For immediate release: June 13, 2005 |
Contact: Matt Heger Primaris Communications Department (800) 735-6776, Ext. 136 |
By Richard A. Royer, Chief Executive Officer, and Gregg Laiben, MD, Medical Director, Regarding June 15 Snyder-Anderson JAMA Study
Results of a study concerning Medicare Quality Improvement Organizations (QIO) and hospital quality of care will tomorrow be published in the Journal of the American Medical Association (JAMA). We welcome attention on this important program, but strongly caution readers to avoid generalizing the published results across the entire QIO community. The Snyder-Anderson study contains a number of methodological flaws that are more or less acknowledged by the authors, rendering it a weak assessment of the QIOs' abilities and accomplishments. Reliable and statistically significant data demonstrate that health care providers have dramatically improved their quality of care after working closely with Primaris, the Medicare QIO for Missouri.
The Snyder-Anderson study focused on assistance provided by a small number of QIOs more than three years ago and implies that groups like Primaris intensively worked with a select group of hospitals. This is not true. Primaris has for the last 20 years provided a wide range of assistance to all Missouri hospitals. Like most other QIOs, we have not and currently do not single out certain hospitals.
During the last two decades Primaris has successfully helped Missouri hospitals develop the internal capacity for quality improvement. Many of these facilities have since established departments that exclusively work on quality improvement projects. The hospital industry, unlike other health care settings, is the benefactor of extensive assistance offered by many different groups together working to accelerate positive change. In light of this, Quality Improvement Organizations have during the last six years increasingly re-diverted their resources toward care settings that need extra help – nursing homes, outpatient physician offices and home health agencies, for example. The assistance we offer hospitals today represents less than 20 percent of our total work, and there are indications that this percentage will be further reduced as we approach decade's end.
Unlike hospitals, however, Primaris does provide intensive one-on-one quality improvement assistance to certain nursing homes, physician offices and home health agencies. The large number of these types of caregivers requires that we concentrate our work in a limited number of sites. Recent national data (as of July 2004) strongly suggest our services accelerate improvement in care. For example:
• Home care agencies that developed a formal plan of action for improvement with a QIO improved far more than their peers who did not. Agencies that worked closely with a QIO on average reduced the number of patients suffering from pain by 23 percent, compared to a 9.2 percent improvement by their peers. Dramatic improvements in the status of patients with urinary incontinence were also accomplished.
• Nursing homes working intensively with a QIO reduced the prevalence residents inchronic pain by 60 percent, compared to the 35 percent improvement realized in other facilities. Similar results were found concerning the number of residents who improved in the ability to perform activities of daily living.
• Physician offices working one-on-one with their local QIO improved the level of care given to diabetic patients faster than their peers. For example, doctors working intensively with a QIO on average improved the percentage of patients who received a biennial lipid profile by more than 46 percent, compared to a 39 percent improvement by their peers. Biennial lipid profiles help physicians assess a patient's risk for cardiovascular disease.
To be sure, Missouri hospital care has also improved during the last three years. Primaris recognizes their outstanding accomplishments, and is proud to have helped them realize these improvements. The percentage of heart attack patients given an aspirin when arriving at the hospital, for example, increased from 78.8 percent to 85.2 percent between 2001 and 2003 – a relative improvement of 30.3 percent. Aspirin can help keep blood clots from forming and dissolve blood clots that can cause heart attacks. The percentage of heart attack patients receiving a beta-blocker (a type of medicine used to lower blood pressure and help prevent future heart attack) also improved, as did the number of pneumonia patients who received an antibiotic within four hours of hospital admission, the time frame when these drugs provide the most benefit to patients.
In addition, the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services, recently completed a national survey of health care providers to gauge their satisfaction with QIO assistance. The results show strong provider support for our efforts. On average, 92 percent of nursing homes, home health agencies, hospitals, physician offices and Medicare Advantage organizations working with a QIO reported being satisfied or very satisfied with the assistance they received.
We encourage researchers to study the efficacy of our assistance on a larger scale, applying a stronger methodological assessment of where our work is headed instead of where it has been. Later this year, in fact, we expect additional studies to be published that demonstrate caregivers are achieving significant improvement as a result of the assistance provided by Medicare Quality Improvement Organizations. Their analysis is based on a sounder methodology.
For more information on how Primaris is helping transform health care quality in Missouri, visit us online at www.primaris.org.
# # #
This material was prepared by Primaris under
contract with the Centers for Medicare & Medicaid Services
(CMS). The contents presented do not necessarily reflect
CMS policy.
Back to Top