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Most Docs Able to Explain Gaps in Quality of Rheumatology Care

Before giving penalties for suboptimal care, important to let physicians provide reasons

THURSDAY, Feb. 14 (HealthDay News) -- Data from the Physician Quality Reporting System (PQRS) for osteoporosis and rheumatoid arthritis (RA) care in Medicare fee-for-service beneficiaries show that up to one-quarter of physicians provided reasons in the system explaining why care was considered but not provided, according to research published in the February issue of Arthritis Care & Research.

In an effort to assess the frequency and nature of physician-reported reasons why recommended care was not provided, Jeffrey R. Curtis, M.D., M.P.H., of the University of Alabama in Birmingham, and colleagues used data from the PQRS for 1,775 physicians reporting on one or more osteoporosis measures, and 630 physicians reporting on one or more RA measures.

The researchers found that 76 percent of patients received the recommended dual X-ray absorptiometry osteoporosis screening. Overall, 82 percent of patients with osteoporosis and 89 percent of RA patients received prescription osteoporosis medication or disease-modifying antirheumatic drug/biologic agent, respectively. Physicians provided medical, patient, system, or other reasons why care was considered but not provided for the remaining 11 to 24 percent of RA and osteoporosis patients.

"Our results suggest that the substantial care gaps previously identified in published osteoporosis and RA studies using administrative data may have been somewhat overestimated because of care that was not provided for a presumed valid reason," the authors write. "Allowing physicians the opportunity to provide reasons why they considered but did not provide care appears useful to inform measurement in quality of care and should be an integral part of quality reporting systems in the future."

All of the authors disclosed financial ties to pharmaceutical companies, including Amgen, which partially funded the study.

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