Journal article
Incidence- Versus Prevalence-Based Measures of Inappropriate Prescribing in the Veterans Health Administration
Journal of the American Geriatrics Society (JAGS), Vol.63(8), pp.1601-1607
08/2015
DOI: 10.1111/jgs.13560
PMID: 26200069
Abstract
To describe variations in potentially inappropriate prescribing (PIP) and characterize the extent to which switching to an incidence-based indicator would affect health system quality rankings. Observational study. Veterans Health Administration in 2011. Older adults receiving outpatient primary care. PIP was defined according to the National Committee for Quality Assurance High-Risk Medications in the Elderly list. Ranks were separately assigned for prevalent and incident PIP at the regional, network, and healthcare system levels. National PIP prevalence was 12.3% (167,766/1,360,251), and incidence was 5.8% (78,604/1,360,251). PIP prevalence ranged from 3.5% to 33.1% across healthcare systems (interquartile range (IQR) = 9.2-15.5%). PIP incidence ranged from 1.2% to 14.9% (IQR = 4.1-7.2%). Rank order in PIP prevalence and incidence was correlated (Spearman correlation; ρ = 0.934, P < .001), although substantial changes in ranks were seen for some healthcare systems, with seven of 139 (5.0%) systems shifting more than 30 rank positions and 21 (15.1%) systems shifting 16 to 30 positions. Prevalence- and incidence-based indicators of prescribing quality were strongly correlated. Transitioning to incidence-based indicators would not produce an initial disruption in quality rankings for most healthcare systems and might yield more-salient measures for tracking healthcare quality.
Details
- Title: Subtitle
- Incidence- Versus Prevalence-Based Measures of Inappropriate Prescribing in the Veterans Health Administration
- Creators
- Brian C Lund - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IowaMargaret Carrel - Department of Geographical and Sustainability Sciences, College of Medicine, University of Iowa, Iowa City, IowaWalid F Gellad - Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PennsylvaniaElizabeth A Chrischilles - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IowaPeter J Kaboli - Division of General Internal Medicine, College of Medicine, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.63(8), pp.1601-1607
- DOI
- 10.1111/jgs.13560
- PMID
- 26200069
- NLM abbreviation
- J Am Geriatr Soc
- ISSN
- 0002-8614
- eISSN
- 1532-5415
- Publisher
- United States
- Grant note
- name: Health Services Research and Development Service, Department of Veterans Affairs, award: CDA 10-017, CIN 13-412, CDA 09-207
- Language
- English
- Date published
- 08/2015
- Academic Unit
- Pharmacy; Epidemiology; Interdisciplinary Programs; Geographical and Sustainability Sciences; Internal Medicine
- Record Identifier
- 9983984542402771
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