Quality of Medical Care Delivered to Medicare Beneficiaries

abstracted from the hospital medicalrecords by 2 clinical data abstractioncenters(whichareadministrativelyin-dependent of individual PROs) usingcomputerizedabstractiontoolswithex-plicit criteria that were developed andtested specifically for these measures.The abstraction tools collected infor-mation on contraindications to thetreatment process being studied. In-formed consent was not required be-cause the data were collected for ad-ministrationoftheMedicareprogram,notforresearch,andaccesstothesedatais given to the program by law. InfluenzaandPneumococcalImmu-nization Rates. We used the BRFSS, 11 whichiscoordinatedbytheCentersforDisease Control and Prevention andcarried out by state health depart-ments, to estimate statewide vaccina-tioncoverage.TheBRFSSisarandom-digit-dialed telephone survey of thenoninstitutionalized adult popula-tion, and the estimates are for all per-sons older than 65 years; the nationalsampleis26469forthisagegroup,witha median state sample of 430 in 1997(estimated from the 1997 BRFSS Pub-licUseDataFile