Care management dosage.
Care management dosage.
复制标题
护理管理剂量。
DOI：
10.1007/s11606-007-0138-z
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发表时间：
2007
影响因子：
5.7
通讯作者：
Brunker,CherieP
中科院分区：
文献类型：
--
作者：
Dorr,DavidA;Wilcox,Adam;Jones,Spencer;Burns,Laurie;Donnelly,StevenM;Brunker,CherieP
背景复杂疾病患者的护理需要仔细的管理，但护理管理系统（CM）在其结构和effectiveness.ObjectiveTo.ObjectiveTo. Create一个框架，确定广泛的CM干预措施的组成部分，并验证该框架，包括使用这个框架来评估慢性病患者结局的不同组成部分的贡献。设计我们使用关于CM的回顾性信息创建框架活动和服务，并使用聚类和因素分析对其进行分类。然后，我们通过内容和标准技术验证这个框架。内容有效性进行评估，通过德尔菲研究和标准有效性通过关系的剂量措施和模式的护理过程和结果measures. PropantsPatients糖尿病和/或心血管疾病接受CM服务的模式称为护理管理加实施在primary care.ResultsSix因素的CM活动，包括一个单一的剂量汇总措施和5个单独的模式的护理。其中，总体剂量汇总测量、面对面时间、随访持续时间和服务范围均与血红蛋白A1 c和LDL检测和控制的改进过程相关。简短的紧张模式的护理和高面对面的护理经理的时间也与改善outcomes.ConclusionsUsing这个框架，我们隔离组件的CM干预直接关系到改善护理过程或患者的结果。目前的努力结构CM，包括面对面的时间和多种疾病进行了讨论。
BackgroundThe care of patients with complex illnesses requires careful management, but systems of care management (CM) vary in their structure and effectiveness.ObjectiveTo create a framework identifying components of broad-based CM interventions and validate the framework, including using this framework to evaluate the contribution of varying components on outcomes of patients with chronic illness.DesignWe create the framework using retrospective information about CM activities and services over 12 months and categorize it using cluster and factor analysis. We then validate this framework through content and criterion techniques. Content validity is assessed through a Delphi study and criterion validity through relationship of the dosage measures and patterns of care to process and outcomes measures.ParticipantsPatients with diabetes and/or cardiovascular disease receiving CM services in a model known as Care Management Plus implemented in primary care.ResultsSix factors of CM activity were identified, including a single dosage summary measure and 5 separate patterns of care. Of these, the overall dosage summary measure, face-to-face time, duration of follow-up, and breadth of services were all related to improved processes for hemoglobin A1c and LDL testing and control. Brief intense patterns of care and high face-to-face care manager time were also related to improved outcomes.ConclusionsUsing this framework, we isolate components of a CM intervention directly related to improved process of care or patient outcomes. Current efforts to structure CM to include face-to-face time and multiple diseases are discussed.