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Researchers measure quality of care in oral anticoagulation
Date:1/3/2011

tudy are threefold. First, TTR varied widely among VA anticoagulation clinics, from 38 percent time in range to 69 percent, or from poor to excellent control. This suggests that some VA sites are already doing very well with this area of care, while others need to improve. Second, while risk-adjustment did not alter performance rankings for many sites, for other sites it made an important difference. For example, the anticoagulation clinic that was ranked 27th out of 100 before risk adjustment was ranked as one of the best (7th) after risk-adjustment. This demonstrates the importance of adjusting TTR for case mix when profiling performance. Third, site performance on risk-adjusted TTR was consistent from year to year, suggesting that risk-adjusted TTR measures a construct (quality of care) that is stable over time, rather than mere statistical variation.

"Our study suggests that risk-adjusted TTR should be considered for more widespread use as a performance measure as part of an effort to improve anticoagulation control and thus improve patient outcomes, said Rose. "In the past, the VA has led efforts to measure and improve quality in other areas of care, and numerous studies have shown that the VA delivers care that is as good as or better than non-VA care. We plan to make the VA a leader in delivering high-quality anticoagulation care as well," he added. The authors note that profiling anticoagulation performance is within the reach of any integrated health care system.

"As a nation, we spend vast amounts of effort and resources profiling performance regarding diabetes, blood pressure, acute coronary syndromes, cancer screening, and commonly performed surgeries," explained Rose. "Until now, we have not tried to profile performance regarding anticoagulation control. This study suggests that we can - and we should."


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Contact: Gina DiGravio
gina.digravio@bmc.org
617-638-8480
Boston University Medical Center
Source:Eurekalert

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