Nursing Homes: Medical Staff Models and Care Correlates

疗养院：医务人员模式和护理相关性

• 批准号: 6852830
• 负责人: PAUL R KATZ
• 金额: $ 12.97万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-02-01 至 2007-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6852830
• 关键词: clinical research; data collection methodology /evaluation; focus groups; health administration; health care facility information system; health care model; health care personnel; health care quality; health care service evaluation; health care service organization; health services research tag; human subject; interview; model design /development; nursing homes; questionnaires

DESCRIPTION (provided by the applicant): The proposal is a feasibility study that pilot tests a methodology to quantify nursing home medical staff organization (NHMSO) and its impact on relevant health care outcomes. Aim I. Construct and pilot test a reliable and valid instrument to measure nursing home medical staff organizational (NHMSO) structure. The NHMSO scale will be developed using input from focus groups and cognitive interviews with experts from the American Medical Directors (AMDA) Research Network. The scaled instrument will be piloted with a random sample of medical directors from AMDA, who represent freestanding nursing facilities. Standard survey techniques will be used (Dilman) with a 10% data check to ensure accuracy of responses entered into the database. Reliability, exploratory factor analysis, and tests for convergent and discriminant validity will be conducted. To further refine and enhance the instrument, a Medical director and administrator self-report will be compared to external observational data on a 1/3 sub-sample of the facilities from the pilot; this will allow the calculation of convergent validity and method variance. Aim II. Initiate a feasibility study of the NHMSO survey instrument using an expanded random sample of medical directors from freestanding facilities drawn from the American Medical Directors Association (AMDA) membership. The feasibility and generalizability of the survey will be determined by calculating response rates as well as cross validation and sub-group analyses. Aim Ill. Implement a pilot study to examine clinical care outcomes associated with NHMSO patterns. The survey results will be merged to available nursing home data (Nursing Home Compare and OSCAR). Multivariate regression techniques, adjusting for confounding facility characteristics, will examine the hypothesized association of NHMSO with the previously defined quality of care metrics. Results of this study and its framework will guide future projects to explore the relationship between medical structure, medical practice patterns and health care outcomes.

描述（由申请人提供）：该提案是一项可行性研究，试点测试了量化疗养院医务人员组织 (NHMSO) 及其对相关医疗保健结果的影响的方法。目标 I. 构建并试点测试一个可靠有效的工具来衡量疗养院医务人员组织 (NHMSO) 结构。 NHMSO 量表将根据焦点小组的意见以及对美国医学主任 (AMDA) 研究网络专家的认知访谈来制定。该缩放工具将由 AMDA 代表独立护理机构的医疗主管随机抽样进行试点。 将使用标准调查技术 (Dilman) 并进行 10% 的数据检查，以确保输入数据库的答复的准确性。将进行可靠性、探索性因素分析以及收敛和判别有效性测试。为了进一步完善和增强该工具，医疗主任和管理人员的自我报告将与试点设施 1/3 子样本的外部观察数据进行比较；这将允许计算收敛有效性和方法方差。目标二。 使用来自美国医疗主任协会 (AMDA) 会员的独立机构的医疗主任扩大随机样本，启动 NHMSO 调查工具的可行性研究。调查的可行性和普遍性将通过计算答复率以及交叉验证和亚组分析来确定。 Aim Ill. 实施一项试点研究来检查与 NHMSO 模式相关的临床护理结果。调查结果将合并到可用的疗养院数据（疗养院比较和 OSCAR）。多元回归技术，根据混杂的设施特征进行调整，将检查 NHMSO 与先前定义的护理质量指标的假设关联。这项研究的结果及其框架将指导未来探索医疗结构、医疗实践模式和医疗保健结果之间关系的项目。