Table 2.
Quality of Outpatient Care Among All Patient Visits to US Resident and Staff Physicians, 1997-2004
| Resident Physician | Staff Physician | χ2 P value | |
|---|---|---|---|
| Visits | Visits | ||
| % (95% CI) | % (95% CI) | ||
| Medical Management of Common Diseases | |||
| (N = number of visits associated with issue) | |||
| ACE inhibitor use for CHF (N = 506) | 57.0 (39.6,74.4) | 27.6 (19.2,36.0) | <0.001a |
| Aspirin use for CAD (N = 944) | 48.4 (25.1,71.7) | 35.8 (27.3,44.2) | NS |
| BB for CAD (N = 903) | 31.9 (20.4,43.4) | 30.9 (23,38.9) | NS |
| Diuretic use for HTN (N = 3020) | 57.8 (51.5, 64.1) | 44.0 (40.5,47.6) | <0.001a |
| IC use for asthma in adults (N = 945) | 38.2 (26.5, 49.8) | 32.3 (24.7, 39.6) | NS |
| Statin use for hyperlipidemia (N = 1269) | 56.3 (48.3, 64.2) | 40.4 (34.9, 45.8) | 0.001a |
| Treatment of depression† (N = 1783) | 65.2 (52.6, 77.9) | 69.2 (63.8, 74.6) | NS |
| No benzodiazepine use for depression (N = 1783) | 100 (100, 100) | 100 (99.9,100) | NS |
| Hemoglobin A1C checked for diabetes§ (N = 922) | 23.3 (10.2, 36.4) | 22.0 (13.1-30.9) | NS |
| Preventive Counseling | |||
| Smoking cessation (N = 493) | 20.7 (8.7,32.6) | 25.6 (17.7,33.4) | NS |
| Diet/nutrition in high-risk adults‡ (N = 732) | 32.0 (20.7,43.2) | 28.3 (21.7,34.9) | NS |
| Exercise in high-risk adults‡ (N = 732) | 16.3 (7.1,25.5) | 15.7 (9.6,21.9) | NS |
| Screening Tests | |||
| Blood pressure screen (N = 8061) | 85.3 (81.1,89.5) | 79.6 (76.4,82.8) | 0.024a |
| No routine ECG (N = 1335) | 95.3 (91.6,99.0) | 91.5 (87.6,95.3) | NS |
| No routine urinalysis (N = 3026) | 48.6 (38.5,58.7) | 53.7 (47.0,60.3) | NS |
| No routine CBC (N = 551) | 88.0 (74.5,100) | 81.5 (74.0,89.1) | NS |
| Appropriate Antibiotic Use | |||
| TMP-SMX or quinolone use for UTI (N = 345) | 62.2 (45.8,78.6) | 60.3 (49.9,70.7) | NS |
| No antibiotic use for URTI (N = 348) | 81.5 (69.0,94.0) | 78.0 (69.5, 86.7) | NS |
| Inappropriate Prescribing in Elderly Patients | |||
| Avoiding potentially inappropriate prescribing in elderly patients (N = 7372) | 93.8 (91.4, 96.1) | 93.2 (91.9,94.6) | NS |
adenotes that significance remains after adjusting for sex, age, race, insurance, and urban location
†treatment of depression is defined as: prescribing antidepressants, psychotherapy or mental health counseling
‡high risk adults is defined as having two or more of the following risk factors for coronary heart disease: a history of smoking, men >45 years old or women >55 years old, hypercholesterolemia, hypertension, or obesity and excluding those with known CAD or diabetes mellitus
§Data only available for 2003 and 2004