Survey of US Practitioners on the Validity of the Medicare Functional Classification Level System and Utility of Clinical Outcome Measures for Aiding K-Level Assignment
Survey of US Practitioners on the Validity of the Medicare Functional Classification Level System and Utility of Clinical Outcome Measures for Aiding K-Level Assignment
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DOI：
10.1016/j.apmr.2016.02.024
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发表时间：
2016-07-01
影响因子：
4.3
通讯作者：
Major, Matthew J.
中科院分区：
文献类型：
--
作者：
Borrenpohl, Dylan;Kaluf, Brian;Major, Matthew J.
目的：描述假肢临床护理社区对医疗保险功能分类级别（K级）分配过程的意见，以分类下肢丧失患者的活动性和康复潜力，包括将结果指标（OM）整合到K级分配的临床实践框架中所涉及的局限性和实用性。设计：调查。设置：研究对象：236名假肢专业人员志愿者。数据进行了分析，仅为美国从业者（n=213）。干预措施：不适用。主要成果措施：主观反应19多项选择，李克特规模，和开放式questions.Results：47%的受访者表示，他们是唯一的决定因素在K级分配过程中，而43%表示，这是一个与其他医疗保健专业人员的协作过程。69%的受访者报告使用标准化OM来协助K级分配，大多数人不同意通常报告的实施障碍（例如，缺乏时间和培训）。百分之六十七的受访者不相信K级系统可以准确地分配一个级别的康复潜力，75%的同意，将OM纳入临床实践将提高客观性的K级assignment process.Conclusions：结果表明，大多数假肢从业者参与的K级分配在一定程度上，大多数同意，有相当大的局限性与此系统。为了解决这些问题，许多从业者正在使用OM来评估患者移动性和康复潜力的各个方面，并最大限度地减少分配过程的主观性。(C)2016年美国康复医学大会
Objective: To characterize the opinion of the prosthetic clinical care community on the Medicare Functional Classification Level (K-level) assignment process to classify the mobility and rehabilitation potential of persons with lower-limb loss, including limitations and practicalities involved with the integration of outcome measures (OMs) into the clinical practice framework for K-level assignment.Design: Survey.Setting: English online questionnaire with built-in logic.Participants: Volunteer sample of prosthetics practitioners (N=236). Data were analyzed only for U.S. practitioners (n=213).Interventions: Not applicable.Main Outcome Measures: Subjective responses to 19 multiple choice, Likert scale, and open-ended questions.Results: Forty-seven percent of respondents indicated that they were the sole determinant in the K-level assignment process, while 43% indicated that it was a collaborative process with other health care professionals. Sixty-nine percent of respondents reported using standardized OMs to assist in K-level assignment, and most did not agree that commonly reported barriers to implementation (eg, lack of time and training) were relevant. Sixty-seven percent of respondents did not believe the K-level system can accurately assign a level of rehabilitation potential, with 75% agreeing that incorporating OMs into clinical practice would enhance objectivity of the K-level assignment process.Conclusions: The results suggest that most prosthetics practitioners are involved in the K-level assignment at some level, and most agreed that there are considerable limitations with this system. To address these issues, many practitioners are using OMs to assess various aspects of patient mobility and rehabilitation potential, and minimize the subjectivity of the assignment process. (C) 2016 by the American Congress of Rehabilitation Medicine