Do claims-based continuity of care measures reflect the patient perspective?

Do claims-based continuity of care measures reflect the patient perspective?
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DOI:
10.1177/1077558713505909
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发表时间:
2014-04
期刊:
Medical care research and review : MCRR
影响因子:
--
通讯作者:
Wolinsky FD
Wolinsky FD
中科院分区:
其他
文献类型:
--
作者:
Bentler SE;Morgan RO;Virnig BA;Wolinsky FD

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护理连续性(CoC)是以患者为中心的医疗之家(PCMH)的基石,也是实现卫生保健质量的主要手段之一。然而,尽管经过数十年的研究,CoC仍然难以定义和量化。要将患者经验纳入医疗改革评估,关键是要确定传统上源自行政索赔的CoC衡量是否以及在多大程度上反映了患者经验。在这项研究中,我们使用了2620名医疗保险受益人的索赔数据和自我报告的连续性经验,他们完成了国家健康和卫生服务使用问卷,以比较16个基于索赔的CoC指数和多维度的患者报告的CoC测量。我们的研究结果表明,大多数基于索赔的CoC测量并不能反映老年人对持续的患者-提供者关系的看法,这表明基于索赔的评估应该与患者报告一起使用,以定义、量化和评估卫生保健服务模式中的CoC。
Continuity of care (CoC) is a cornerstone of the patient-centered medical home (PCMH) and one of the primary means for achieving health care quality. Despite decades of study, however, CoC remains difficult to define and quantify. To incorporate patient experiences into health reform evaluations, it is critical to determine if and how well CoC measures traditionally derived from administrative claims capture patient experiences. In this study, we used claims data and self-reported continuity experiences of 2,620 Medicare beneficiaries who completed the National Health and Health Services Use Questionnaire to compare 16 claims-based CoC indices to a multidimensional patient-reported CoC measure. Our results show that most claims-based CoC measures do not reflect older adults’ perceptions of continuous patient–provider relationships, indicating that claims-based assessments should be used in tandem with patient reports for defining, quantifying, and evaluating CoC in health care delivery models.
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