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Nursing Homes: Medical Staff Models and Care Correlates

疗养院：医务人员模式和护理相关性

基本信息

批准号：
7011211
负责人：
PAUL R KATZ
金额：
$ 13.58万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-02-01 至 2007-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7011211
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

项目摘要

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，旨在对量化养老院医务人员组织（NHMSO）及其对相关卫生保健结果的影响的方法进行试点测试。目的：构建一种可靠有效的养老院医务人员组织结构测量工具并进行中试。NHMSO量表将根据焦点小组的意见和对美国医学主任（AMDA）研究网络专家的认知访谈来制定。该仪器将在AMDA随机抽取代表独立护理机构的医疗主任进行试验。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回答的准确性。信度、探索性因子分析、收敛效度和判别效度检验将会进行。为了进一步完善和加强这一工具，将把医务主任和行政人员的自我报告与试点设施三分之一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。目的二世。利用从美国医务主任协会（AMDA）成员中抽取的独立设施的医务主任扩大随机抽样，启动国家卫生保健服务组织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回复率以及交叉验证和亚组分析来确定。目的生病。实施一项试点研究，以检查与NHMSO模式相关的临床护理结果。调查结果将合并到现有的养老院数据（养老院比较和奥斯卡）。多变量回归技术，调整混杂设施特征，将检验NHMSO与先前定义的护理质量指标的假设关联。本研究的结果及其框架将指导未来的项目探索医疗结构、医疗实践模式和卫生保健结果之间的关系。