Association of physicians' accuracy in recording with quality of care in cardiovascular medicine

被引:19
作者
Giorda, Carlo Bruno [1 ,2 ]
Guida, Piero [3 ]
Avogaro, Angelo [4 ]
Cortese, Claudio [5 ]
Mureddu, Gian Francesco [6 ]
Corsini, Alberto [7 ]
Comaschi, Marco Antonio [8 ]
Manzato, Enzo [9 ]
Volpe, Massimo [10 ,11 ]
Zito, Giovanni Battista [12 ]
Medea, Gerardo
Ventriglia, Giuseppe
Titta, Giulio
Riccardi, Gabriele [13 ]
机构
[1] Maggiore Hosp, Diabet & Metab Unit, ASL Turin 5, I-10023 Chieri, TO, Italy
[2] Chaira Med Assoc, Chieri, TO, Italy
[3] Univ Bari, Cardiol Unit, Bari, Italy
[4] Univ Padua, Padua, Italy
[5] Univ Roma Tor Vergata, Dept Internal Med, Rome, Italy
[6] San Giovanni Addolorata Hosp, Dept Cardiovasc Dis, Rome, Italy
[7] Univ Milan, Dept Pharmacol Sci, Milan, Italy
[8] San Martino Hosp, Dept Emergency, Genoa, Italy
[9] Univ Padua, Dept Med & Surg Sci, Padua, Italy
[10] Univ Roma La Sapienza, Fac Med 2, Div Cardiol, Rome, Italy
[11] IRCCS Neuromed, Pozzilli, IS, Italy
[12] ASL Napoli 5, Cardiol Unit, Pompei, NA, Italy
[13] Univ Naples Federico II, Naples, Italy
来源
EUROPEAN JOURNAL OF CARDIOVASCULAR PREVENTION & REHABILITATION | 2009年 / 16卷 / 06期
关键词
cardiovascular risk management; clinical appropriateness; medical records; ELECTRONIC HEALTH RECORDS; PREVENTION; DISEASE; GUIDELINES; EVENTS;
D O I
10.1097/HJR.0b013e3283317c3f
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Physicians' adherence to cardiovascular (CV) guidelines has been found to be poor. In this regard, accuracy in keeping medical records could play an important role. This study was devised to describe which data are present in medical records from a large sample of physicians and to investigate the association and the link between completeness in recording and clinical appropriateness. Methods The data extracted from medical records of 1078 doctors (general practitioners, cardiologists, and diabetologists) were analyzed, with a focus on CV prevention. The percentage of recorded data of several CV clinical variables was calculated. A multivariate analysis was performed to investigate the association between doctors' and patients' characteristics and different patterns in recording. Finally, the completeness in recording was calculated with a score and plotted against three indicators of appropriateness. Results The only risk factor that achieved a good standard of registration was blood pressure (89%). Low-density lipoprotein and waist circumference were largely under-recorded, whereas lifestyle data collection was almost negligible. Age, specialization, and use of electronic records increase the accuracy in recording. When one CV risk factor was predominant, the probability of having other risk factors recorded was reduced. A significant increase in the proportion of patients treated according to guidelines was found in doctors who were more accurate in recording. Conclusion A link exists between accuracy in recording with both quality of care and adherence to guidelines. Specific training of all doctors in this field should be considered. Eur J Cardiovasc Prev Rehabil 16:722-728 (C) 2009 The European Society of Cardiology
引用
收藏
页码:722 / 728
页数:7
相关论文
共 19 条
[1]  
*ATP, 3 ATP
[2]   Citizens and family doctors facing awareness and management of traditional cardiovascular risk factors: Results from the global cardiovascular risk reduction project (Help Your Heart Stay Young Study) [J].
Celentano, A ;
Panico, S ;
Palmieri, V ;
Guillaro, B ;
Brancati, C ;
Esposito, ND ;
Arezzi, E ;
Setola, C ;
Piccinocchi, G ;
Canfora, G ;
Rubba, P ;
Di Minno, G ;
Mancini, M .
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES, 2003, 13 (04) :211-217
[3]   Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [J].
Chobanian, AV ;
Bakris, GL ;
Black, HR ;
Cushman, WC ;
Green, LA ;
Izzo, JL ;
Jones, DW ;
Materson, BJ ;
Oparil, S ;
Wright, JT ;
Roccella, EJ .
HYPERTENSION, 2003, 42 (06) :1206-1252
[4]   Quality of diabetes care predicts the development of cardiovascular events: Results of the QuED study [J].
De Berardis, Giorgia ;
Pellegrini, Fabio ;
Franciosi, Monica ;
Belfiglio, Maurizio ;
Di Nardo, Barbara ;
Greenfield, Sheldon ;
Kaplan, Sherrie H. ;
Rossi, Maria C. E. ;
Sacco, Michele ;
Tognoni, Gianni ;
Valentini, Miriam ;
Nicolucci, Antonio .
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES, 2008, 18 (01) :57-65
[5]   Electronic health records in ambulatory care - A national survey of physicians [J].
DesRoches, Catherine M. ;
Campbell, Eric G. ;
Rao, Sowmya R. ;
Donelan, Karen ;
Ferris, Timothy G. ;
Jha, Ashish ;
Kaushal, Rainu ;
Levy, Douglas E. ;
Rosenbaum, Sara ;
Shields, Alexandra E. ;
Blumenthal, David .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 359 (01) :50-60
[6]   Secondary prevention of coronary artery disease in high-risk diabetic patients [J].
Giorda, C ;
Maggini, M ;
Alegiani, SS ;
Turco, S ;
Raschetti, R .
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES, 2003, 13 (04) :238-243
[7]   European guidelines on cardiovascular disease prevention in clinical practice: executive summary [J].
Graham, Ian ;
Atar, Dan ;
Borch-Johnsen, Knut ;
Boysen, Gudrun ;
Burell, Gunilla ;
Cifkova, Renata ;
Dallongeville, Jean ;
De Backer, Guy ;
Ebrahim, Shah ;
Gjelsvik, Bjorn ;
Herrman-Lingen, Christoph ;
Hoes, Arno ;
Humphries, Steve ;
Knapton, Mike ;
Perk, Joep ;
Priori, Silvia G. ;
Pyorala, Kalevi ;
Reiner, Zeljko ;
Ruilope, Luis ;
Sans-Menendez, Susana ;
Reimer, Wilma Scholte op ;
Weissberg, Peter ;
Wood, David ;
Yarnell, John ;
Zamorano, Jose Luis .
EUROPEAN HEART JOURNAL, 2007, 28 (19) :2375-2414
[8]   Accuracy in the recording of pressure ulcers and prevention after implementing an electronic health record in hospital care [J].
Gunningberg, L. ;
Dahm, M. Fogelberg ;
Ehrenberg, A. .
QUALITY & SAFETY IN HEALTH CARE, 2008, 17 (04) :281-285
[9]   Definition, structure, content, use and impacts of electronic health records:: A review of the research literature [J].
Hayrinen, Kristiina ;
Saranto, Kaija ;
Nykanen, Pirkko .
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS, 2008, 77 (05) :291-304
[10]   Nurse-led motivational interviewing to change the lifestyle of patients with type 2 diabetes (MILD-project): protocol for a cluster, randomized, controlled trial on implementing lifestyle recommendations [J].
Jansink, Renate ;
Braspenning, Joze ;
van der Weijden, Trudy ;
Niessen, Louis ;
Elwyn, Glyn ;
Grol, Richard .
BMC HEALTH SERVICES RESEARCH, 2009, 9