Trends over 8  years in quality of @entity6 care: results of the XXXX Annals continuous quality improvement initiative.

@entity1 @entity6 @entity13785 @entity164 @entity165
OBJECTIVE: Quality of care monitoring is a key strategy for health policy. In Italy, the @entity13785 Annals continuous monitoring and quality improvement initiative has been in place since 2006. Results after 8  years are now available. RESEARCH DESIGN AND METHODS: Quality of @entity6 care indicators during the years 2004-2011 were extracted from electronic medical records of 300 @entity6 clinics. From 200,000 to 500,000 @entity1 with @entity164 2 @entity6 were analyzed per year. Six process indicators, eight intermediate outcome indicators, seven indicators of treatment intensity/appropriateness, and a quality of care summary score (Q score) were evaluated. Previous studies documented that the risk of developing a new cardiovascular event was 80  % higher in @entity1 with a Q score <15 and 20  % higher in those with a score between 15 and 25, as compared to those with a score >25. RESULTS: The proportion of @entity1 with HbA1c  <=7  %, LDL @entity165 <100  mg/dl, and blood pressure >= 140/90  mmHg increased by 4.8, 21.9, and 10.0  %, respectively. Process and treatment intensity/appropriateness indicators consistently improved. The proportion of @entity1 with a Q score <15 decreased from 13.5 to 6.5  %, while those with a Q score >25 increased from 22.9 to 38.5  %. CONCLUSIONS: @entity13785 Annals document the progress in quality of @entity6 care. Longitudinal improvements in Q score can translate into less cardiovascular events, with evident clinical and economic implications. @entity13785 Annals represent a physician-led effort not requiring allocation of extra-economic resources, which is easy to implement and deeply rooted in routine clinical practice. They are a potential case model for other healthcare systems.
