Table 3 Receipt of recommended care by indicator among medicare beneficiaries (2001–2008) by age group
Recommended care indicator | Overall N = 30,117 | Age < 65 5201 (16.3%) | Age 65–74 11,289 (47.5%) | Age ≥ 75 13,627 (36.2%) | P-value for difference among age groups | |
|---|---|---|---|---|---|---|
Raw numerator/denominator | Weighted percent (%) | Weighted percent (%) | Weighted percent (%) | Weighted percent (%) | ||
Acute Myocardial Infarction (AMI) | ||||||
 Visit within 4 weeks following discharge of patients hospitalized for acute myocardial infarction | 231/298 | 79 | 84 | 79 | 78 | 0.748 |
 Cholesterol test every 6 months for patients hospitalized for myocardial infarction who have hypercholesterolemia | 224/365 | 64 | 71 | 69 | 58 | 0.188 |
Anemia | ||||||
 Gastrointestinal workup for patients with iron deficiency anemia no later than 3 months after iron deficiency | 355/1112 | 33 | 34 | 37 | 30 | 0.273 |
 Hematocrit/hemoglobin between 1 and 6 months following initial diagnosis of anemia | 1723/2576 | 68 | 67 | 67 | 69 | 0.633 |
Angina | ||||||
 Visit within 4 weeks following discharge of patients hospitalized for unstable angina | 193/234 | 83 | 76 | 83 | 86 | 0.407 |
 Visit every 6 months for patients with chronic stable angina | 1826/1940 | 94 | 92 | 93 | 96 | 0.135 |
 Follow-up visit or hospitalization within 4 weeks of initial diagnosis of unstable angina | 196/236 | 84 | 77 | 82 | 89 | 0.150 |
 Lipid profile within 6 months after initial diagnosis of angina | 59/767 | 9 | X | 14 | 4 | 0.0003 |
Breast Cancer | ||||||
 Interval from biopsy and definitive therapy less than 3 months for patients with breast cancer and eventual mastectomy | 60/79 | 73 | X | 70 | 81 | 0.273 |
 Mammogram within 3 months preceding an initial diagnosis of breast cancer | 110/182 | 61 | X | 60 | 63 | 0.917 |
 Chest x-ray within 3 months preceding or following initial diagnosis of breast cancer | 96/182 | 51 | 43 | 54 | 51 | 0.631 |
 Visit within 12 months for breast cancer patients who have undergone mastectomy without cytotoxic chemotherapy | 71/71 | 100 | X | 100 | 100 | N/A |
 Mammography every year for patients with a history of breast cancer | 416/629 | 69 | 70 | 78 | 61 | 0.0004 |
Cerebrovascular Accident (CVA) | ||||||
 Carotid imaging within 2 weeks of initial diagnosis for patients hospitalized for carotid artery stroke | 235/312 | 75 | 95 | 68 | 75 | <.0001 |
 Interval between carotid imaging and carotid endarterectomy less than 2 months for cerebrovascular accident patients with eventual carotid endarterectomy | 112/134 | 84 | X | 87 | 83 | 0.501 |
 Visit within 4 weeks following discharge of patients for cerebrovascular accident | 379/571 | 67 | 57 | 75 | 64 | 0.011 |
Transient Ischemic Attack (TIA) | ||||||
 Electrocardiogram within 2 days of initial diagnosis of transient ischemic attack | 92/621 | 15 | X | 16 | 14 | 0.748 |
 Interval between carotid imaging and carotid endarterectomy less than 2 months for TIA patients with eventual carotid endarterectomy | 45/54 | 85 | X | 91 | 82 | 0.012 |
 Visit within 4 weeks following discharge of patients hospitalized for transient ischemic attack | 184/237 | 79 | 61 | 95 | 74 | <.0001 |
 Visit every year for patients with diagnosis of transient ischemic attack | 1540/1596 | 97 | 96 | 97 | 96 | 0.740 |
Cholelithiasis | ||||||
 Cholecystectomy within 1 month preceding or 3 months following diagnosis of cholelithiasis and one or more of the following: cholecystitis, cholangitis, gallstone pancreatitis | 282/699 | 41 | 43 | 48 | 34 | 0.030 |
Chronic Obstructive Pulmonary Disease (COPD) | ||||||
 Visit every 6 months for patients with chronic obstructive pulmonary disease | 4732/5197 | 91 | 90 | 91 | 92 | 0.236 |
Congestive Heart Failure (CHF) | ||||||
 Chest x-ray within 3 months of initial diagnosis of congestive heart failure | 1097/1580 | 69 | 72 | 64 | 71 | 0.067 |
 Electrocardiogram within 3 months of initial diagnosis of congestive heart failure | 1023/1578 | 66 | 67 | 66 | 66 | 0.953 |
 Visit within 4 weeks following discharge of patients hospitalized for congestive heart failure | 490/663 | 74 | 71 | 82 | 70 | 0.032 |
 Visit every 6 months for patients with congestive heart failure | 4142/4527 | 92 | 91 | 93 | 91 | 0.201 |
Depression | ||||||
 Visit within 2 weeks following discharge of patients hospitalized for depression | 95/173 | 53 | 49 | 55 | 57 | 0.593 |
Diabetes Mellitus (DM) | ||||||
 Glycosylated hemoglobin every 6 months for patients with diabetes | 3499/6756 | 54 | 52 | 58 | 50 | <.0001 |
 Eye exam every year for patients with diabetes | 3160/6491 | 49 | 34 | 50 | 54 | <.0001 |
 Visit within 4 weeks following discharge of patients hospitalized for diabetes | 295/430 | 68 | 71 | 63 | 70 | 0.466 |
 Visit every 6 months for patients with diabetes | 6185/6756 | 92 | 89 | 92 | 92 | 0.036 |
Gastrointestinal Bleeding | ||||||
 Visit within 4 weeks following discharge of patients hospitalized for gastrointestinal bleeding | 273/373 | 73 | 51 | 74 | 78 | 0.001 |
 Hematocrit within 4 weeks following discharge of patients hospitalized for gastrointestinal bleeding | 201/373 | 54 | 36 | 57 | 58 | 0.025 |
 Follow-up visit within 4 weeks of initial diagnosis of gastrointestinal bleeding | 491/676 | 74 | 74 | 77 | 69 | 0.195 |
Hypertension | ||||||
 Visit within 4 weeks following discharge of patients hospitalized with malignant or otherwise severe hypertension | 49/74 | 63 | X | 62 | 76 | 0.0002 |
Preventive Care | ||||||
 Visit every year | 17,905/19,535 | 92 | 87 | 91 | 94 | <.0001 |
 Assessment of visual impairment every 2 years | 9363/16,759 | 56 | 34 | 57 | 64 | <.0001 |
 Mammography every 2 years for females aged between 45 and 75 (inclusive) years | 2728/4240 | 65 | 58 | 67 | 61 | <.0001 |