0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Population and Primary Health Care Characteristics and Coronary Heart Disease Mortality

Tara Kiran, MD, MSc; Irfan A. Dhalla, MD, MSc
JAMA. 2011;305(8):778-779. doi:10.1001/jama.2011.155.
Text Size: A A A
Published online

Extract

To the Editor: Although it is probably true that population characteristics such as poverty, smoking, and diabetes explain most of the variation in CHD mortality, the availability and quality of primary care are also important.1

Dr Levene and colleagues2 concluded that clinical performance in the English primary health care system does not predict CHD mortality. This may be a consequence of the quality measures that they chose to include in their model. Three of their 6 quality measures used the proportion of Quality and Outcomes Framework points achieved by practices in a region as a proxy for the quality of primary care. For most indicators in the framework, the maximum number of points can be achieved even when targets are missed in a significant proportion of patients. For example, for the hypertension indicator, a practice receives the maximum number of available points if 70% of their patients with hypertension have a blood pressure at or below 150/90 mm Hg.3 Most practices in England achieve virtually all the available points, leaving little variation with which to explore the hypothesis that higher-quality care is associated with improved outcomes.4

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

February 23, 2011
Peter Cummings, MD, MPH
JAMA. 2011;305(8):778-779. doi:10.1001/jama.2011.154.
February 23, 2011
Louis S. Levene, MB, BChir; Richard Baker, MD; M. John G. Bankart, MSc, PhD
JAMA. 2011;305(8):778-779. doi:10.1001/jama.2011.156.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();