OUTCOME ASSESSMENT/PATIENTS WITH BILIARY TRACT DISEASE

结果评估/胆道疾病患者

• 批准号: 3372135
• 负责人: J. SANFORD SCHWARTZ
• 金额: $ 119.1万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-08-01 至 1995-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3372135
• 关键词: Medicare /Medicaid; biliary tract disorder; biliary tract disorder diagnosis; cholelithiasis; decision making; diagnosis quality /standard; disease /disorder prevention /control; health /scientific organization; health behavior; health care cost /financing; health care model; health care service evaluation; health care service utilization; health insurance; health surveys; human therapy evaluation; literature survey; medical complication; medical indigency; model design /development; patient care management; preference; primary care physician; prognosis; sign /symptom; therapy compliance

The objective of this project is to improve the evaluation, management and health outcomes of patients with biliary tract disease. The specific aims are: to determine the rates of use, variation in rates of use and health outcomes associated with alternative diagnostic tests and therapeutic modalities; to identify appropriate indications for the use of alternative tests and treatments and optimal management strategies; to use this information to help practicing physicians improve their practice patterns and the health outcomes of their patients; to assess the impact of the interventions on physician practice and health outcomes; and to demonstrate the feasibility of strategies involving physicians in developing and implementing effective intervention programs. The project also will contribute to our understanding and use of health services research methodologies, including the usefulness of specific types of claims data in evaluating the outcomes of care, the relative advantages of disease specific versus generic measures of functional status and health outcome, the stability of patient preferences over time and across disease states, the generalizability of consensus statements across groups of physicians and the effectiveness of alternative community based interventions in changing physician behavior. This project represents a collaborative effort by research staff at the University of Pennsylvania and practicing physicians and professional societies in eastern Pennsylvania. Three cities in eastern Pennsylvania will serve as intensive intervention sites; one city will serve as a control site. The remainder of eastern pennsylvania will receive a less intensive intervention. Western Pennsylvania will not receive any intervention and will serve as a control. The project will have 7 stages: (1) synthesis of existing medical literature and information; (2) analysis of existing claims data; (3) collection of primary data on outcomes of care and on physician and patient preferences; (4) development of a normative model of optimal management strategies; (5) development of practice guidelines; (6) development of interventions to encourage use of these guidelines; and (7) use of primary and claims data measure the impact of the interventions on utilization and outcomes.

该项目的目标是改善评估、管理和 胆道疾病患者的健康结局。具体目标 是：确定使用率、使用率的变化和健康 与替代诊断测试和治疗相关的结果 方式；确定使用替代物的适当适应症 测试和治疗以及最佳管理策略；使用这一点 帮助执业医生改进执业模式的信息 以及他们患者的健康结果；评估 关于医生执业和健康结果的干预措施；并展示 让医生参与制定和实施战略的可行性 实施有效的干预计划。 该项目还将有助于我们对健康的理解和使用 服务研究方法，包括特定类型的有用性 在评估护理结果时，索赔数据的相对优势 疾病特异度与功能状态和健康的通用量度 结果，患者偏好随时间和跨疾病的稳定性 国家，各集团的共识声明的概括性 以医生和社区替代方案为基础的有效性 改变医生行为的干预措施。 这个项目代表了研究人员在 宾夕法尼亚大学和执业医生和专业人士 宾夕法尼亚州东部的社团。宾夕法尼亚州东部的三个城市 将作为密集干预地点；一个城市将作为 控制点。宾夕法尼亚州东部的其余地区将收到较少的 强化干预。宾夕法尼亚州西部将不会收到 并将作为一种控制措施。该项目将分为7个阶段： (1)现有医学文献和信息的综合；(2)分析 现有索赔数据；(3)关于护理结果的主要数据的收集 以及医生和患者的偏好；(4)制定规范性的 最优管理策略模型；(5)实践发展 准则；(6)制定干预措施，鼓励使用这些 准则；和(7)使用原始数据和索赔数据衡量 关于利用和结果的干预措施。