The quality of care for adults with epilepsy: an initial glimpse using the QUIET measure

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  • Pugh, Mary Jo
    • Other Affiliation: South Texas Veterans Health Care System
  • Berlowitz, Dan R
    • Other Affiliation: Center for Health Quality, Outcomes and Economic Research (CHQOER), Veterans Administration Medical Center
  • Rao, Jaya K
    • Affiliation: Eshelman School of Pharmacy
  • Shapiro, Gabriel
    • Other Affiliation: Boston University School of Public Health
  • Avetisyan, Ruzan
    • Other Affiliation: Boston University School of Public Health
  • Hanchate, Amresh
    • Other Affiliation: Boston Veterans Administration Medical Center
  • Jarrett, Kelli
    • Other Affiliation: Boston University School of Public Health
  • Tabares, Jeffrey
    • Other Affiliation: South Texas Veterans Health Care System
  • Kazis, Lewis E
    • Other Affiliation: Center for Health Quality, Outcomes and Economic Research (CHQOER), Veterans Administration Medical Center
Abstract
  • Background We examined the quality of adult epilepsy care using the Quality Indicators in Epilepsy Treatment (QUIET) measure, and variations in quality based on the source of epilepsy care. Methods We identified 311 individuals with epilepsy diagnosis between 2004 and 2007 in a tertiary medical center in New England. We abstracted medical charts to identify the extent to which participants received quality indicator (QI) concordant care for individual QI's and the proportion of recommended care processes completed for different aspects of epilepsy care over a two year period. Finally, we compared the proportion of recommended care processes completed for those receiving care only in primary care, neurology clinics, or care shared between primary care and neurology providers. Results The mean proportion of concordant care by indicator was 55.6 (standard deviation = 31.5). Of the 1985 possible care processes, 877 (44.2%) were performed; care specific to women had the lowest concordance (37% vs. 42% [first seizure evaluation], 44% [initial epilepsy treatment], 45% [chronic care]). Individuals receiving shared care had more aspects of QI concordant care performed than did those receiving neurology care for initial treatment (53% vs. 43%; X2 = 9.0; p = 0.01) and chronic epilepsy care (55% vs. 42%; X2 = 30.2; p < 0.001). Conclusions Similar to most other chronic diseases, less than half of recommended care processes were performed. Further investigation is needed to understand whether a shared-care model enhances quality of care, and if so, how it leads to improvements in quality.
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Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Mary Pugh et al.; licensee BioMed Central Ltd.
Journal title
  • BMC Health Services Research
Journal volume
  • 11
Journal issue
  • 1
Page start
  • 1
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1472-6963
Bibliographic citation
  • BMC Health Services Research. 2011 Jan 03;11(1):1
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • August 23, 2012

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file details 1472-6963-11-1.pdf 2019-05-07 Public Download
file details Quality in epilepsy treatment in adults (QUIET) indicators. This file includes the specific quality indicators included in the QUIET measure. 2019-05-07 Public Download
file details 1472-6963-11-1.xml 2019-05-07 Public Download
file details CDC epilepsy quality of care study: patients' medical record review_abstraction form. This file includes the chart abstraction form used to collect data on quality of care from patients' electronic medical record. 2019-05-07 Public Download