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To the Editor.— In their article on quality of care and outcomes in elderly patients with pneumonia, Dr Meehan and colleagues¹ underscore important aspects in the process of patient care. The authors confirm that quality of patient care differs markedly within the United States, a finding that also has been shown previously in critically ill patients.² The authors used quality-of-care indicators obtained from a hospital survey, literature reviews, and expert panels to assess process-of-care performance. When they studied the relationship between the adherence to these quality indicators and survival in elderly patients with pneumonia, the authors showed that early administration of antibiotics and blood culture collection within 24 hours of admission were significantly related to a better outcome.

The authors suggest that early administration of antibiotics and early blood culture collection could have improved therapy, but unfortunately do not report the relationship between antibiotic administration prior to hospitalization and survival. . . . [Full Text of this Article]

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RELATED ARTICLE

Quality of Care, Process, and Outcomes in Elderly Patients With Pneumonia
Thomas P. Meehan, Michael J. Fine, Harlan M. Krumholz, Jeanne D. Scinto, Deron H. Galusha, Joyce T. Mockalis, Georgina F. Weber, Marcia K. Petrillo, Peter M. Houck, and Jonathan M. Fine
JAMA. 1997;278(23):2080-2084.
ABSTRACT