RESUMO
OBJECTIVES: In light of large variation in the quality of medical care, this study assesses the extent to which medical care for depressed elders is consistent with systematic quality standards. METHOD: Using the Donabedian model, we assess factors related to two quality measures: medical service fit and medical provider contact. We assessed 110 depressed older adults with comorbid conditions through practical guidelines of medical services. RESULTS: We found large variation in the quality of medical care and differences between two quality measures. Structure (Medigap insurance and clinical factors) and process factors (medical professional visits, ER visits, and adequacy of informal care) influenced the quality of medical care. CONCLUSION: Emphasizing accuracy in quality measures, quality disparities by medical conditions call attention to the risky population with certain conditions targeted for closer follow-up. Appropriate medical care processes can enhance the quality.
