American journal of medical quality : the official journal of the American College of Medical Quality
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Comparative Study
Comparison of the Agency for Healthcare Research and Quality Patient Safety Indicator Rates Among Veteran Dual Users.
This study compares rates of 11 Agency for Healthcare Research and Quality Patient Safety Indicators (PSIs) among 266 203 veteran dual users (ie, those with hospitalizations in both the Veterans Health Administration [VA] and the private sector through Medicare fee-for-service coverage) during 2002 to 2007. PSI risk-adjusted rates were calculated using the PSI software (version 3.1a). ⋯ VA had significantly higher rates for 7 of the remaining 8 PSIs, although the rates of only 2 PSIs (postoperative hemorrhage/hematoma and accidental puncture or laceration) remained higher in the VA after sensitivity analyses were conducted. A better understanding of system-level differences in coding practices and patient severity, poorly documented in administrative data, is needed before conclusions about differences in quality can be drawn.
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Long waits for appointments decrease patient satisfaction. Administrative wait-time measures are used by managers, but relationships between these measures and satisfaction have not been studied. Data from the Veterans Health Administration are used to examine the relationship between wait times and satisfaction. ⋯ Logistic regression models predict patient satisfaction using these measures. The new-patient capacity, new-patient time stamp measures using CD, and the returning-patient desired-date prospective measure were significantly associated with patient satisfaction. Standard practices can be improved by targeting wait-time measures to patient subpopulations.