Structure, process, and outcomes in stroke rehabilitation
Structure, process, and outcomes in stroke rehabilitation
复制标题
DOI：
10.1097/00005650-200211000-00005
复制
发表时间：
2002-11-01
期刊：
影响因子：
3
通讯作者：
Hamilton, BB
中科院分区：
文献类型：
--
作者：
Hoenig, H;Duncan, PW;Hamilton, BB
BACKGROUND. The health services research framework of structure, process, and outcome is used commonly to examine quality of care, and it indicates that structure influences process, which in turn influences outcomes. However, little empirical work has been done to test this hypothesis, particularly for medical rehabilitation.OBJECTIVES. To determine if, among stroke patients, (1) structure of care was associated with process of care, and (2) structure of care was associated with outcomes after adjusting for process.RESEARCH DESIGN. Two-year, prospective study of 288 acute stroke patients in 11 VA medical centers, of whom 128 were included in the current analysis.MEASURES. Structure of care: systemic organization, staffing expertise, and technological sophistication. Process of care: compliance with the AHCPR poststroke rehabilitation guidelines. Patient characteristics: baseline prior walking ability and Functional Independence Measure (FIM) motor subscale. Outcomes: the FIM motor subscale 6-months poststroke.RESULTS. The combination of systemic organization and staffing expertise, along with technological sophistication, were independent predictors of process of care (beta coefficients 0.21, P
