24:I[63208,["8920","static/chunks/8920-efbff8517d590b7e.js","9097","static/chunks/9097-7e60ff382fede0de.js","5914","static/chunks/5914-356082358a498a0b.js","9903","static/chunks/9903-11222066602aad8e.js","5438","static/chunks/5438-cfc6cd3ec63ed58c.js","3851","static/chunks/3851-d9d99b9df58ccefb.js","4621","static/chunks/4621-60797c2425663d2a.js","6871","static/chunks/6871-85cb03c97585f46a.js","6736","static/chunks/6736-932312a004c99faf.js","4550","static/chunks/4550-0bf059e3050c08b3.js","688","static/chunks/688-a6a2ac7bff269cd3.js","3984","static/chunks/3984-063c0b62f32133c7.js","7038","static/chunks/7038-4f87670d4e55ef18.js","9039","static/chunks/9039-75366c62dc7d0d0e.js","4563","static/chunks/4563-ad980d1babbf7b0b.js","6761","static/chunks/6761-0c10d1446de7ae1c.js","744","static/chunks/744-1e76229abb9e297b.js","7342","static/chunks/7342-1586df78600bf911.js","3617","static/chunks/3617-1f62a097637f4747.js","5895","static/chunks/5895-caa6c774914eb108.js","7481","static/chunks/7481-3b84c503a2ebfb3f.js","3668","static/chunks/3668-7dab69e4121c33af.js","39","static/chunks/39-e93a27d0920e6d92.js","2881","static/chunks/2881-445cc2384af2c6f9.js","2364","static/chunks/2364-e83d52fb21729d99.js","3208","static/chunks/3208-e65462d166bd3688.js","7582","static/chunks/app/toc/%5Btla%5D/%5Bvolume%5D/%5Bissue%5D/page-694a0e465c2c1334.js"],"default"] 25:T432,

The authors examined the implications of dual-system use for risk adjustment and quality assessment. The sample (n = 34 151) included all veterans dually enrolled in the Veterans Health Administration (VA) and the private sector in 1998 with (1) an inpatient discharge from either a VA or Medicare setting for 1 of 6 conditions/procedures and (2) inpatient and/or outpatient use in both the VA and private sector. The authors used the Diagnostic Cost Groups risk-adjustment system to obtain concurrent and prospective health status (relative risk scores) using veterans’ Medicare diagnoses only, VA diagnoses only, and diagnoses from both systems. Both concurrent and prospective relative risk scores increased when diagnoses from both systems were used; the population’s disease profile also was affected. The authors conclude that it is important to capture the true disease burden of the population by obtaining diagnoses from all health care systems providing care to facilitate meaningful comparisons of performance.

26:T4b7,

Although asthma quality improvement (QI) programs are common, little is known about the scope and content of QI initiatives in managed care arrangements. The authors conducted a cross-sectional survey of all managed care plans in Michigan serving the pediatric Medicaid population. Using semi-structured interviews, they assessed the comprehensiveness of the asthma QI program regarding provider, allied health professional, pharmacy, and member services. Although all QI initiatives included some type of physician-directed component and patient-directed components, only half included allied health professionals and one quarter included pharmacy-directed components. Interactive physician continuing medical education was associated with plans whose members were concentrated in only 1 or 2 counties. The authors noted wide variation in content, format, inclusion of incentives, inclusion of other health professionals, and outcome goals. The variation in QI approaches by each of the managed care organizations suggests that there is a dearth of information on appropriate and cost-effective methods to improve pediatric asthma quality at the plan level.

27:T441,

This study employed a retrospective cohort analysis using New York State’s Statewide Planning and Research Cooperative System (SPARCS) to improve the Patient Safety Indicator (PSI) definition of postoperative hemorrhage/hematoma (POHH) and to identify patient risk factors associated with POHH. Study participants were nonobstetric, inpatient surgical admissions in SPARCS and readmissions within 30 days with