OUTCOME ASSESSMENT/PATIENTS WITH BILIARY TRACT DISEASE

结果评估/胆道疾病患者

• 批准号: 3098978
• 负责人: J. SANFORD SCHWARTZ
• 金额: $ 107.7万
• 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 1995-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3098978
• 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.

该项目的目标是改进评估、管理和 胆道疾病患者的健康结果。 具体目标 是：确定使用率、使用率变化和健康状况 与替代诊断测试和治疗相关的结果 方式；确定使用替代品的适当指征 测试和治疗以及最佳管理策略；使用这个 帮助执业医师改善执业模式的信息 以及患者的健康结果；评估影响 对医生执业和健康结果的干预；并展示 涉及医生制定和制定策略的可行性 实施有效的干预计划。 该项目还将有助于我们理解和利用健康 服务研究方法，包括特定类型的有用性 索赔数据在评估护理结果时的相对优势 疾病特异性与功能状态和健康的一般测量的比较 结果，患者偏好随时间和疾病的稳定性 国家之间的共识声明的普遍性 医生和基于社区的替代方案的有效性 改变医生行为的干预措施。 该项目代表了该中心研究人员的共同努力 宾夕法尼亚大学执业医师和专业人士 宾夕法尼亚州东部的社团。 宾夕法尼亚州东部的三个城市 将作为密集干预场所；一个城市将作为 控制站点。 宾夕法尼亚州东部的其余地区将获得较少的 密集干预。 宾夕法尼亚州西部将不会收到任何 干预并作为对照。 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) 收集护理结果的原始数据 以及医生和患者的偏好； (4) 制定规范 最优管理策略模型； (5)实践发展 指导方针； (6) 制定干预措施以鼓励使用这些 指导方针； (7) 使用主要数据和索赔数据来衡量 对利用和结果的干预措施。