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October 24/31, 2001

Improving Care for Elderly Patients With Peptic Ulcer DiseaseShould the Focus Be on Drugs or Bugs?

Author Affiliations

Author Affiliations: Center for Health Services Research (Drs Butler, Ness, and Speroff) and Center for Clinical Improvement (Dr Speroff), Divisions of Cardiovascular Medicine (Dr Butler) and Gastroenterolgy (Dr Ness), and Departments of Medicine (Drs Butler, Ness, and Speroff) and Preventive Medicine (Dr Speroff), Vanderbilt University Medical Center, and Medical Service, Tennessee Valley Health Care System—Nashville Campus (Drs Butler, Ness, and Speroff), Nashville.

JAMA. 2001;286(16):2023-2024. doi:10.1001/jama.286.16.2023

In this issue of THE JOURNAL, Brock and colleagues1 report the results of their study assessing quality improvement in process of care, as recommended by evidence-based clinical guidelines,2,3 for elderly patients hospitalized for peptic ulcer disease (PUD). Data for this study were derived from a quality improvement project conducted by peer review organizations (PROs) in 5 states. Although these databases are not designed primarily to answer scientific questions, the data collection and analyses are conducted rigorously. These data sources have been used to study several important issues, including assessing health care quality,4 identifying opportunities for improvement,5 evaluating effectiveness of care for patients not typically studied in randomized clinical trials (RCTs),6 developing risk adjustment models,7 assessing quality improvement interventions,8 and performing traditional epidemiologic and clinical research.9,10 Data from the Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration) and from PROs have been invaluable in improving patient care through research.

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