Seidman J J, Weiss K B
Consumer Health Initiative, Advisory Board Company, Washington, DC, USA.
Am J Manag Care. 2001 Jun;7(6):567-72.
Managed care represents an important system of healthcare delivery in the United States and the primary source of care for many persons with asthma.
To characterize how US managed care health plans address the quality of asthma care through the use of disease-specific quality improvement (QI) programs complying with National Committee for Quality Assurance (NCQA) standards.
This study was a cross-sectional review of reports from all accreditation surveys conducted in 1996 and 1997 by the NCQA. Each accreditation report was reviewed for evidence of whether the health plan explored asthma care as a way to demonstrate compliance with NCQA accreditation standards. Asthma activity was examined with respect to health plan characteristics such as size of plan and Medicaid contracting. Types of asthma QI activity, use of guidelines, and application of different NCQA accreditation standards were also examined.
Approximately 90% of 197 health plans undergoing NCQA accreditation surveys in 1996 and 1997 reported some form of asthma QI activity. There were no statistically significant differences in this activity in large vs small plans or in plans with vs without Medicaid members. Approximately two thirds of health plans used asthma QI activities to meet NCQA accreditation standards in health management systems, and three fifths monitored and evaluated important aspects of asthma care and service.
During the study period, many US health plans conducted asthma care QI activities. The recently released NCQA asthma performance measure may provide the next assessment of how well managed care is contributing to improving asthma care in the United States.
管理式医疗是美国重要的医疗服务提供体系，也是许多哮喘患者的主要医疗服务来源。
描述美国管理式医疗健康计划如何通过使用符合国家质量保证委员会（NCQA）标准的特定疾病质量改进（QI）计划来解决哮喘护理质量问题。
本研究是对NCQA在1996年和1997年进行的所有认证调查的报告进行的横断面审查。审查每份认证报告，以寻找健康计划是否将哮喘护理作为证明符合NCQA认证标准的一种方式的证据。针对健康计划的特征，如计划规模和医疗补助合同情况来检查哮喘活动。还检查了哮喘QI活动的类型、指南的使用以及不同NCQA认证标准的应用情况。
在1996年和1997年接受NCQA认证调查的197个健康计划中，约90%报告了某种形式的哮喘QI活动。在大型计划与小型计划之间，以及有医疗补助成员的计划与没有医疗补助成员的计划之间，这种活动在统计学上没有显著差异。约三分之二的健康计划利用哮喘QI活动来满足健康管理系统中的NCQA认证标准，五分之三的计划监测和评估哮喘护理及服务的重要方面。
在研究期间，许多美国健康计划开展了哮喘护理QI活动。最近发布的NCQA哮喘绩效指标可能会对管理式医疗在美国改善哮喘护理方面的贡献程度进行下一次评估。
