QUALITY OUTCOMES IN SUBACUTE AND HOME CARE PROGRAMS

该项目将在两年内开发评估护理质量的方法 急性住院后的危重过渡环境；亚急性 养老院计划和家庭护理计划。 这是一项分三个阶段的研究工作，涉及使用两种类型的 一次数据和大量使用大型、多状态的次要数据 基地。第一组主要数据将用于验证八个结果 测量(ADL、活动能力、认知、沟通、肠道、膀胱、疼痛、 和情绪)基于与独立收集的集合的比较测试 平行措施。主要数据收集计划的这一方面将是 在HRCA拥有的护理单元和家庭护理环境中完成或与 HRCA与谁保持着持续的研究实验室关系。那里 每个平行表格分析将有200个案例。 第二组主要数据将作为真实世界的一部分进行收集 模型的可行性试验。将完成以患者为基础的评估 在所有研究年中，项目站点的人员对结果进行评分 度量和协变量。重点将放在新入院的患者身上。 这些计划，在基线、90天和出院时进行评估。 这些数据将为棱镜健康集团提供服务的患者收集 -750名亚急性患者和450名家庭护理患者。棱镜将提供场 网站，包括其熟练的护理设施和家庭健康计划 马萨诸塞州用于测试和验证以下结果衡量标准 来自广泛诊断类别的患者通常在 急诊后护理..对于这个项目，棱镜公司已经同意建立MDS-HC 在其家庭健康计划中收集数据。 辅助数据将从辅助来源提取，以支持协变量 模型开发和建立基准纵向变化 参数。使用这些数据，我们将完成主要分析 本研究的活动，利用高质量， 来自多个州的项目的计算机化评估数据。 HRCA的家庭护理数据集目前包含约3,000个 病人。HRCAs亚急性养老院多状态数据集是一个庞大的和 包含在TAHE中的最小数据集(MDS)评估的广泛数据库 UMAAP档案。该数据库保存着MDS评估数据，代表12 各州疗养院的人口。截至1995年，UMAAP包含超过2.7个 描述约150万居民个人的100万条记录。 结构和行政指标以及流程服务措施将 被录入。用于预测不同时间间隔内状态变化的模型将 创建；其中状态更改在二分式和 连续条款。

The project will develop methods for evaluating quality of care within two critical transitional settings following acute hospitalization; subacute nursing home programs and home care programs. This is a three-phase study effort, involving the use of two types of primary data and the extensive use of a large, multi-state secondary data base. The first set of primary data will be used to validate eight outcome measures (ADLs, mobility, cognition, communication, bowel, bladder, pain, and mood) based on comparative, tests with independently gathered sets of parallel measures. This aspect of primary data gathering program will be completed in nursing units and home care settings owned by HRCA or with whom HRCA maintains an ongoing research laboratory relationship. There will be 200 cases for each of the parallel form analyses. The second set of primary data will be gathered as part of a real-world feasibility trial of model. Patient-based assessments would be completed in all study years, with program sites' personnel scoring the outcome measures and covariates. The focus will be on patients newly admitted to these programs, with assessments at baseline, 90 days, and at discharge. These data will be gathered for patients served by the Prism Health Group -- 750 subacute and 450 home care patients. Prism will provide field sites it both its skilled nursing facilities and home health programs in Massachusetts for testing and validation of the outcome measures for patients from a broad range of diagnostic categories typically served in post-acute care.. For this project, Prism has agreed to institute MDS-HC data collection in its home health programs. Secondary data will be drawn from secondary sources to support covariate model development and to establish benchmark longitudinal change parameters. Using these data, we will complete the major analytic activities of this study, taking advantage of the high quality, computerized assessment data derived from programs in multiple states. HRCA's home-care data set currently encompasses approximately 3,000 patients. HRCAs subacute nursing home multi-state data set is a large and broad database of Minimum Data Set (MDS) assessments contained within tahe UMAAP archive. The database holds MDS assessment data representing 12 states' nursing home population. As of 1995, UMAAP contained over 2.7 million records describing approximately 1.5 million individual resident. Structural and administrative indicators and process-services measures will be entered. Models to predict change in status over various intervals will be created; where status change is defined in both dichotomous and continuous terms.