For people who expected large quality-of-care differences, this effect was even greater (OR = 7.44 [95% CI: [2.28 24.3]).
Our study documents the feasibility of conducting practice-based quality-of-care studies across large numbers of outpatient practices— after having reached a consensus on how to measure quality in priority areas.
The evidence for better outcome of complex, low-volume surgical procedures in high-volume centers and the large disparities in quality of care between high- and low-volume centers have fueled the discussion about centralization.
However, to our knowledge there is no routine use of outcome-based QIs for monitoring the quality of acute care for the illnesses and syndromes characteristic of old age despite the large emphasis on quality of care for these patients in the literature over the past 10 years [ 16].
The lessons learned from using a structured public health approach to improve on a large scale the quality of care for people with chronic diseases in developing countries may also be relevant to countries in the developed world, especially those where the poor and disadvantaged have limited access to ongoing healthcare provision (e.g. USA).
This could be interpreted as a result of large gains in the quality of care in recent years.
Hospital physicians working conditions not only affect their own well-being, but to a large degree also the quality of care their patients receive [ 1- 4].
Geographical differences also have been described, including large variations in the quality of care between districts within the state of Thuringia in Germany (20) and between states in the United States (21).
Relative to the other explanatory variables, state had a large impact on PARC use, which was contrary to what we hypothesized, but consistent with a body of literature showing that where you live has a large influence on the quality of care you receive.
Hence if larger practices provide better quality of care; this would have important implications for the future organization of primary care services.
QOF introduction resulted in a larger increase in the quality of care for men than for women, decreasing this gap [ 30].
