Trends in Outpatient Quality Indicators

Principal Investigator: Randall S. Stafford 
Funding Agency: Agency for Healthcare Research and Quality 
Duration: 07/01/2002 - 06/30/2006

Despite increasing attention on overall health care quality improvement in the U.S., the national quality of outpatient health care services has not been adequately evaluated. Particularly lacking are strict appraisals of trends in the quality of outpatient care for racial and ethnic minorities. Data from the 1992-2001 National Ambulatory Medical Care Surveys (NAMCS) and National Hospital Ambulatory Medical Care Surveys (NHAMCS) will be used to assess this concern.

Ideally we will be able to construct a set of outpatient quality indicators that will:

1) assess at the national level,
2) evaluate time trends, and 
3) determine patient, physician and organizational predictors with a particular focus on racial/ethnic minorities.

Thirty-one proposed indicators () will provide a significant evaluation of quality covering:'

1) recommended medications (e.g., warfarin in atrial fibrillation), 
2) antibiotic use (e.g., antibiotics in viral respiratory infections), 
3) physician counseling/disease management (e.g., dietary counseling in diabetes), 
4) diagnostic testing (e.g., screening urinalysis tests), and 
5) medication errors (e.g., risky drug-drug interactions).

This national data, a total of 575,000 visits recorded over a 10 year period will represent a sample of outpatient visits to private doctor's offices (NAMCS) and to hospital outpatient departments (NHMACS). This project will support the Agency for Healthcare Research and Quality's plans for a National Healthcare Quality Report and a Nation Healthcare Dispairities Report Annually. A report of this kind is vital to health policy decision-makers. Such data are central to judging and redirecting approaches that seek to diminish racial/ethnic disparities in health care and health outcomes.

View a list of recent research publications and abstracts from the Trends in Outpatient Quality Indicators Project