Do Medicare's Patient-Reported Outcome Measures Collection Windows Accurately Reflect Academic Clinical Practice?
Do Medicare's Patient-Reported Outcome Measures Collection Windows Accurately Reflect Academic Clinical Practice?
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DOI：
10.1016/j.arth.2019.11.006
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发表时间：
2020-04-01
影响因子：
3.5
通讯作者：
Jevsevar, David S.
中科院分区：
文献类型：
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作者：
Molloy, Ilda B.;Yong, Taylor M.;Jevsevar, David S.
工作背景：关节置换综合护理（CJR）要求收集合格全髋关节和全膝关节置换术的患者报告结局指标（PROM）（THA和TKA）手术，这在常规学术实践中可能无法实现。方法：我们对前瞻性收集的PROM数据进行了回顾性分析，这些数据来自2017年完成Patient-报告结果测量信息系统-术前或术后10个全球健康调查。主要结局是与270-396天的延长术后收集期相比，每个CJR收集期（术前90-0天和术后270-365天）的患者报告结局测量信息系统-10的完成率。采用双变量分析和Logistic回归分析调查完成率与患者特征之间的关联。结果：在2017年860例初次THA和TKA中，725例（84.3%）在术前900天完成了术前调查。在725例患者中，215例（29.7%）在270-365天的CJR时间轴内完成了术后调查。在270-396天的额外术后时间段内，完成率增加了120次额外调查（+16.5%）（P < .001）。没有患者或手术因素与术后PROM完成的可能性较高显著相关（所有协变量P > 0.05）。结论：在学术临床实践中，THA和TKA患者的术后PROM完成率作为CJR规定期间常规临床实践的一部分较低。CJR可以考虑在365天之外增加时间，以提高PROM完成率。(C)2019爱思唯尔公司All rights reserved.
Background: The Comprehensive Care for Joint Replacement (CJR) mandates collection of patient-reported outcome measures (PROMs) for eligible total hip and total knee arthroplasty (THA and TKA) procedures during specific time periods that may not be attainable within routine academic practice.Methods: We performed a retrospective analysis of prospectively collected PROM data from a 2017 cohort of primary THA and TKA patients who completed the Patient-Reported Outcomes Measurement Information System-10 global health survey in preoperative or postoperative time periods. The primary outcome was completion rates of Patient-Reported Outcomes Measurement Information System-10 per the CJR collection periods (90-0 days preoperative and 270-365 days postoperative) compared to an extended postoperative collection period of 270-396 days. Bivariate analysis and logistic regression were used to analyze the association between survey completion rates and patient characteristics.Results: Of the 860 primary THAs and TKAs in 2017, 725 (84.3%) had preoperative surveys completed 900 days before surgery. Among the 725 patients, 215 (29.7%) completed postoperative surveys within the CJR timeline of 270-365 days. Completion increased by 120 additional surveys (+16.5%) in the additional postoperative time period of 270-396 days (P < .001). No patient or procedural factors significantly correlated with a higher likelihood of postoperative PROM completion (P > .05 for all covariates).Conclusion: In an academic clinical practice, completion rates of postoperative PROMs as part of routine clinical practice within the CJR mandated period was low for THA and TKA patients. CJR may consider additional time beyond 365 days to improve PROM completion rates. (C) 2019 Elsevier Inc. All rights reserved.