Quality of Care for General Medical Conditions

A Review of the Literature and Quality Indicators

Edited by Eve A. Kerr, Steven M. Asch, Eric G. Hamilton, Elizabeth A. McGlynn


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This report is one of five volumes providing detailed information on the QA Tools, RAND’s comprehensive, clinically based system for assessing quality of care for children and adults. The QA Tools indicators encompass screening, diagnosis, treatment, and follow-up in 46 clinical areas and cover a variety of modes of providing care, including history,physical examination, laboratory study, medication, and other interventions and contacts. Development of each indicator was based on the ratings of a panel of experts in the relevant fields and on a focused review of the scientific literature, which is clearly documented for each clinical condition. This volume focuses on indicators for care of general medical conditions. Each chapter summarizes the results of the literature review for a particular condition, provides RAND staff’s recommended indicators based on that review, and notes the level of scientific evidence supporting each indicator along with the relevant citations. In addition, this work details the process by which the expert panel evaluated the indicators and the final disposition of each indicator. Clinical conditions covered in this volume are: Acne, alcohol dependence, allergic rhinitis, benign prostatic hyperplasia, cataracts, cholelithiasis, dementia, depression, diabetes mellitus, hormone replacement therapy, headache, hip fracture, hysterectomy, inguinal hernia, acute low back pain, orthopedic conditions. Other RAND Health titles on the QA Tools system focus on indicators for children and adolescents, oncology and HIV, cardiopulmonary conditions, and women.

Table of Contents

  • Preface

  • Tables

  • Figures

  • Acknowledgements


  • Introduction

  • Chapter 1


  • Chapter 2

    Alcohol Dependence

  • Chapter 3

    Allergic Rhinitis

  • Chapter 4

    Benign Prostatic Hyperplasia (BPH)

  • Chapter 5


  • Chapter 6


  • Chapter 7


  • Chapter 8


  • Chapter 9

    Diabetes Mellitus

  • Chapter 10

    Hormone Replacement Therapy

  • Chapter 11


  • Chapter 12

    Hip Fracture

  • Chapter 13


  • Chapter 14

    Inguinal Hernia

  • Chapter 15

    Low Back Pain (Acute)

  • Chapter 16

    Orthopedic Conditions

  • Chapter 17

    Osteoarthritis Treatment

  • Chapter 18

    Dyspepsia and Peptic Ulcer Disease

  • Chapter 19

    Preventive Care

  • Chapter 20

    Vaginitis and Sexually Transmitted Diseases

  • Chapter 21

    Urinary Tract Infection

  • Chapter 22

    Vertigo and Dizziness

  • Appendix A

    Panel Rating Summary by Condition

  • Appendix B

    Crosswalk Table of Original and Final Indicators

The study was conducted within RAND Health and supported by the Agency for Healthcare Research and Quality.

This report is part of the RAND Corporation Monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

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