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 急性住院后的临界过渡环境;亚急性 疗养院项目和家庭护理项目。 这是一个三阶段的研究工作，涉及使用两种类型的 一次数据和大量、多状态二次数据的广泛使用 基地 第一组原始数据将用于验证八个结果 测量（ADL、活动性、认知、沟通、肠、膀胱、疼痛， 和情绪）的基础上进行比较，测试与独立收集的 平行措施。 这方面的主要数据收集程序将 在HRCA拥有的护理单位和家庭护理环境中完成， HRCA与其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例病例。 第二组原始数据将作为真实世界的一部分收集， 模型的可行性试验。 将完成基于患者的评估 在所有研究年中，项目地点的工作人员对结果进行评分， 测量和协变量。 重点将放在新入院的患者身上， 这些项目，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 它的专业护理设施和家庭健康计划都位于 马萨诸塞州进行结果测量的测试和验证， 来自广泛诊断类别的患者通常在 急性期后护理 对于这个项目，棱镜已同意研究MDS-HC 家庭健康计划中的数据收集。 次要数据将从次要来源中提取，以支持协变量 模型开发和建立基准纵向变化 参数 利用这些数据，我们将完成主要的分析。 这项研究的活动，利用高质量， 计算机化的评估数据来自多个州的项目。 HRCA的家庭护理数据集目前包括大约3，000个 患者 HRCAs亚急性疗养院多状态数据集是一个大的， 包含最小数据集（MDS）评估的广泛数据库 UMAAP档案。 该数据库保存MDS评估数据，代表12 国家养老院人口。 截至1995年，UMAAP包含超过2.7 记录了大约150万个居民。 结构和行政指标以及流程服务措施将 进入。 预测不同时间段内状态变化的模型将 创建;其中状态更改以二分和 连续项。

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.