XXXX in primary care: measuring the quality of care.

@entity1 @entity712 @entity1289 @entity340 @entity1284
BACKGROUND: Concerns exist about the quality of care provided to @entity712 @entity1 by primary care physicians. Using an evidence-based clinical guideline, we evaluated the care given to @entity1 with @entity712 . METHODS: We retrospectively reviewed the medical records of 420 @entity1 from 25 primary care practices in upstate New York who had received a diagnosis of @entity712 . Chart documentation confirmed the diagnosis (n = 395). We excluded @entity1 with noncardiogenic @entity1284 or correctable @entity340 (n = 338). Performance profiles measured use of diagnostic tests, left ventricular ejection fraction (LVEF) measurement, @entity1 education, and prescription of @entity1289 ( @entity1289 ) inhibitors. For treatment recommendations, @entity1 were classified according to LVEF status. RESULTS: Only 82% of the @entity1 studied had an LVEF test result documented in their charts. Of these, 49% had an LVEF < or = 40%. @entity1289 inhibitor use was greater among @entity1 with low LVEF (91%) than among those with a normal LVEF (62%). Among @entity1 with @entity712 taking @entity1289 inhibitors, 87% were at target doses. Adherence measures were low for laboratory evaluation and @entity1 -education criteria. CONCLUSIONS: @entity712 with normal LVEF was as prevalent as @entity712 in these primary care practices. Performance profiles for the physicians' prescriptions of @entity1289 inhibitors exceeded those published in the literature. @entity1 who did not have a documented measure of LVEF, however, received lower quality of care as measured by this disease-specific guideline. This underscores the importance of measuring LVEF.
