Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) Physical Functioning Items.
Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) Physical Functioning Items.
复制标题
医疗保险消费者对医疗保健提供者和系统 (CAHPS) 身体功能项目的评估。
DOI：
10.1097/mlr.0000000000000475
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发表时间：
2016-02
期刊：
影响因子：
3
通讯作者：
Elliott MN
中科院分区：
文献类型：
--
作者：
Hays RD;Mallett JS;Gaillot S;Elliott MN
身体机能是成年人的一个重要健康领域。评估医疗保险受益人的身体功能项目。调查数据来自2010年CAHPS® Medicare调查。366，701名受访者中，58%为女性; 38%为75岁或以上; 57%的人受过高中或以下教育。步行、上下椅子、洗澡、穿衣、用餐和进食被评估为3个回答选项：无法做到、有困难、没有困难。Pearson相关系数为0.515 ~ 0.835（α = 0.92）。单因素分类因子分析模型拟合效果较好（比较拟合指数= 0.998;近似均方根误差= 0.083）。受访者报告没有困难的项目比例最高的是吃饭，其次是游泳，穿衣，洗澡，进出椅子和走路。项目反应理论（IRT）分级反应模型的阈值参数范围为-1.983（无法行动和进食困难之间）至-0.551（行走困难和无困难之间）。项目判别参数范围为4.632（步行）至8.228（穿衣）。身体功能评分与自我评定的一般健康状况（r = 0.389，n = 344，843，p < 0.0001）和慢性疾病数量（r =-0.229，n = 284，507，p < 0.0001）相关。身体机能项目针对相对容易的活动，为样本中身体机能水平最低的少数人提供信息。大多数医疗保险受益人都需要代表更高水平身体功能的物品。
Physical functioning is an important health domain for adults. Evaluate physical functioning items in Medicare beneficiaries. Survey data from the 2010 CAHPS® Medicare survey. The 366,701 respondents were 58% female; 38% were 75 or older; 57% had high school education or less. Walking, getting in or out of chairs, bathing, dressing, toileting, and eating assessed with 3 response choices: unable to do, have difficulty, do not have difficulty. Pearson correlations among the 6 items ranged from 0.515 to 0.835 (coefficient alpha = 0.92). A single factor categorical factor analytic model fit the data well (comparative fit index = 0.998; root mean square error of approximation = 0.083). The item with the highest percentage of respondents reporting no difficulty was eating, followed by toileting, dressing, bathing, getting in and out of a chair, and walking. Threshold parameters from an item response theory (IRT) graded response model ranged from −1.983 (between unable to do and have difficulty for eating) to −0.551 (between have difficulty and no difficulty for walking). Item discrimination parameters ranged from 4.632 (walking) to 8.228 (dressing). Physical functioning scores correlated with self-rated general health (r = 0.389, n = 344,843, p < 0.0001) and number of chronic conditions (r = −0.229, n = 284,507, p < 0.0001). The physical functioning items target relatively easy activities, providing information for a minority of people in the sample with the lowest levels of physical functioning. Items representing higher levels of physical functioning are needed for the majority of the Medicare beneficiaries.