The quality of care received by vulnerable elderly Medicare, Medicaid patients is barely acceptable, a team of U.S. researchers report.

   Researchers at the University of California, Los Angeles, used quality of care measurements developed by the Assessing Care of Vulnerable Elders project to look at 43 specific types of care received by more than 100,000 community-dwelling people, average age 81, in 19 California counties between 1999 and 2000.

   The study found that vulnerable elderly patients -- those at risk of death or functional decline -- received only 65 percent of tests and other diagnostic evaluations and treatments recommended for a number of illnesses and conditions, including diabetes and heart disease.

   "Thirty-five percent of the medical care interventions they should have received were not provided, indicating significant room for improvement. We'd much rather have everything higher -- say, at least 90 percent," lead author Dr. David S. Zingmond, assistant professor of general internal medicine and health services research at UCLA's David Geffen School of Medicine, said in a prepared statement.

   One specific example cited by Zingmond and his colleagues: Only 42 percent of patients with diabetes were tested to assess their blood sugar control or received an eye examination during the one-year period covered by the study.

   The findings are published in the October issue of the journal Medical Care.

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