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Quality of Care for Hypertension and Diabetes in Federal- Versus Commercial-Managed Care Organizations

Section of Primary Care, VA Medical Center, Houston, Tex, and Department of Medicine, Baylor College of Medicine, Houston, Tex, hardeeps{at}bcm.tmc.edu

J. Kalavar, MD

Primary Care, VA Medical Center, Houston, Tex

Initiatives to improve quality in primary care include use of performance measures to benchmark health care organizations. We looked for an objective way to compare primary care quality in the Veterans Affairs (VA) with that of private sector. We analyzed performance measures of the Health Plan and Employer Data Information Set (HEDIS) used in ambulatory care for hypertension and diabetes and compared a sample data from a network of VA hospitals with those from National Committee for Quality Assurance's The State of Health Care Quality 2002 Report. The VA data were comparable to the national data. Performance on the hypertension control measure was slightly below the HEDIS national average but better than the regional commercial average. VA's performance on all diabetes measures was higher. Although the VA network had a large influx in patient base recently, the quality of outpatient care in hypertension and diabetes as measured by standardized performance indicators in the network compared favorably with commercial Health Maintenance Organizations in the private sector.

Key Words: Health care quality • HEDIS measures • primary care • veterans affairs

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