Measuring Care Continuity: A Comparison of Claims-based Methods.
Measuring Care Continuity: A Comparison of Claims-based Methods.
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DOI：
10.1097/mlr.0000000000000018
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发表时间：
2016-05
期刊：
影响因子：
3
通讯作者：
Schneider EC
中科院分区：
文献类型：
--
作者：
Pollack CE;Hussey PS;Rudin RS;Fox DS;Lai J;Schneider EC
评估护理连续性对于评估医疗保健改革和医疗保健服务变化的影响非常重要。已经开发了多种护理连续性措施，用于索赔数据。本研究探讨了替代性连续性措施是否提供了明确的评估协调内预定义的事件的护理。回顾性队列研究，使用2008-9年索赔文件的全国5%样本的受益人充血性心力衰竭，慢性阻塞性肺病和糖尿病。护理连续性的四项措施之间的相关性-Bice-Boxerman护理连续性指数，赫芬达尔指数，通常的护理提供者，和顺序护理连续性指数-在提供者和实践水平。在这三种情况下，结果四个索赔为基础的护理协调措施高度相关的提供者水平（皮尔逊相关系数r = 0.87至0.98）和实践水平（r = 0.75至0.98）。结果的相关性也很高，为相同的措施之间的供应商和实践水平（r = 0.65至0.92）。基于索赔的护理连续性措施在护理过程中彼此高度相关。
Assessing care continuity is important in evaluating the impact of health care reform and changes to health care delivery. Multiple measures of care continuity have been developed for use with claims data. This study examined whether alternative continuity measures provide distinct assessments of coordination within pre-defined episodes of care. Retrospective cohort study using 2008–9 claims files for a national 5% sample of beneficiaries with congestive heart failure, chronic obstructive pulmonary disease, and diabetes mellitus. Correlation among four measures of care continuity—the Bice-Boxerman Continuity of Care Index, Herfindahl Index, usual provider of care, and Sequential Continuity of Care Index—derived at the provider- and practice-levels. Across the three conditions, results on four claims-based care coordination measures were highly correlated at the provider level (Pearson correlation coefficient r = 0.87 to 0.98) and practice level (r = 0.75 to 0.98). Correlation of the results was also high for the same measures between the provider and practice levels (r = 0.65 to 0.92). Claims-based care continuity measures are all highly correlated with one another within episodes of care.