Process of Care Measurements for Medicare Quality of Care
November 1, 2000
Process of Care Measurements for Medicare Quality of Care
Acute Myocardial Infarction
4 Administration of aspirin within 24 hours of admission — 84%
4 Aspirin prescribed at discharge — 85%
4 Administration of beta-blocker within 24 hours of admission — 64%
4 Beta-blocker prescribed at discharge — 72%
4 ACE inhibitor prescribed at discharge for patients with left ventricular ejection faction <40% — 71%
4 Smoking cessation counseling given during hospitalization — 40%
4 Time to angioplasty in minutes — 20 (includes states with fewer than 10 cases; interpret with caution)
4 Time to thrombolytic therapy in minutes — 20 (includes states with fewer than 10 cases; interpret with caution)
Heart Failure
4 Evaluation of left ventricular ejection fraction — 65%
4 ACE inhibitor prescribed at discharge for patients with left ventricular ejection fraction <40% — 69%
Stroke
4 Warfarin prescribed for patients with atrial fibrillation — 55%
4 Antithrombotic prescribed at discharge for patients with acute stroke or transient ischemic attack — 83%
4 Avoidance of sublingual nifedipine for patients with acute stroke — 95%
Pneumonia (inpatient)
4 Antibiotic within eight hours of arrival at hospital — 85%
4 Antibiotic consistent with current recommendations — 79%
4 Blood culture drawn (if done) before antibiotic given — 82%
4 Patient screened for or given influenza vaccine — 14%
4 Patient screened for or given pneumococcal
vaccine — 11%
Pneumonia (any setting)
4 Influenza immunization given every year — 66%
4 Pneumococcal immunization given at least once — 46%
Breast Cancer (any setting)
4 Mammogram at least every two years — 56%
Diabetes (any setting)
4 Hemoglobin A1c given at least every year — 71%
4 Eye examinations given at least every two years — 69%
4 Lipid profile done at least every two years — 57%
Source: Health Care Financing Administration, Baltimore.