Inclusion of short-term care patients affects the perceived performance of specialists: A retrospective cohort study Quality, performance, safety and outcomes

Mark A. Nyman, Rosa L. Cabanela, Juliette T. Liesinger, Paula J. Santrach, James M Naessens

Research output: Contribution to journalArticle

1 Scopus citations


Background: Current publicly reported quality performance measures directly compare primary care to specialty care. Specialists see short-term patients referred due to poor control of their disease who then return to their local provider. Our study looked to determine if outcomes measured in short-term care patients differed from those in long-term care patients and what impact those differences may have on quality performance profiles for specialists. Methods: Retrospective cohort from a large academic medical Center. Performance was measured as "Optimal Care" - all or none attainment of goals. Patients with short-term care (<90 days contact) versus long-term care (>90 days contact) were evaluated for both specialty and primary care practices during the year 2008. Results: Patients with short-term care had significantly lower "Optimal Care": 7.2% vs. 19.7% for optimal diabetes care in endocrinology and 41.3% vs. 53.1% for optimal ischemic vascular disease care in cardiology (p∈<∈0.001). Combining short and long term care patients lowered overall perceived performance for the specialty practice. Conclusions: Factors other than quality affect the perceived performance of the specialty practice. Extending current primary care quality measurement to short-term specialty care patients without adjustment produces misleading results.

Original languageEnglish (US)
Article number99
JournalBMC Health Services Research
Issue number1
StatePublished - 2015



  • Long term care
  • Performance measurement
  • Short-term care
  • Specialty care

ASJC Scopus subject areas

  • Health Policy

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