The American journal of managed care
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To measure primary nonadherence (PNA) rates for 10 therapeutic drug groups and identify factors associated with PNA to chronic and acute medications. ⋯ Overall PNA was 9.8% but individual PNA rates varied by therapeutic drug group. Factors of PNA were mostly consistent across drug groups, but some depended on whether the treatment was acute or chronic.
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To refine a previously published standardized quality and utilization measurement set for migraine care and to establish performance benchmarks. ⋯ This study demonstrates the value of standardized measures in identifying potential quality issues for migraine care, including underdiagnosis, overutilization of imaging, and underutilization of preventive drugs.
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Over the past 2 decades, numerous studies have demonstrated the existence of racial disparities in patient care in the United States. Specifically, African Americans with diabetes are less likely to have recommended process of care measures performed and outcome benchmarks for quality of care. ⋯ African American patients with diabetes were as likely or more likely to have recommended process of care measures performed. In spite of this, intermediate diabetes outcomes were still poorer in the same African American population.
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To examine the association between preventable hospitalization rates and proportions of managed care enrollment at the primary care service area level. ⋯ Despite increased managed care enrollment, the role of Medicare managed care in explaining declines in preventable hospitalization rates diminished over time. The results could be explained by the growth of private fee-for-service types of managed care plans and the resultant decline in emphasis on care coordination relative to health maintenance organization plans.