Harris Alex H S, Humphreys Keith, Bowe Thomas, Tiet Quyen, Finney John W
Center for Health Care Evaluation, Department of Veterans Affairs, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, CA 94025, USA.
J Behav Health Serv Res. 2010 Jan;37(1):25-39. doi: 10.1007/s11414-008-9142-2.
This study examines the patient-level associations between the Health Plan Employer Data and Information Set (HEDIS) substance use disorder (SUD) treatment engagement quality indicator and improvements in clinical outcomes. Administrative and survey data from 2,789 US Department of Veterans Affairs SUD patients were used to estimate the effects of meeting the HEDIS engagement criterion on improvements in Addiction Severity Index Alcohol, Drug, and Legal composite scores. Patients meeting the engagement indicator improved significantly more in all domains than patients who did not engage, and the relationship was stronger for alcohol and legal outcomes for patients seen in outpatient settings. The benefit accrued by those who engaged was statistically significant but clinically modest. These results add to the literature documenting the clinical benefits of treatment entry and engagement. Although these findings only indirectly support the use of the HEDIS engagement measure for its intended purpose-discriminating quality at the facility or system level-they confirm that the processes of care captured by the measure are associated with important patient outcomes.
本研究探讨了健康计划雇主数据与信息集（HEDIS）物质使用障碍（SUD）治疗参与质量指标与临床结局改善之间患者层面的关联。利用来自2789名美国退伍军人事务部SUD患者的行政和调查数据，估算达到HEDIS参与标准对成瘾严重程度指数酒精、药物和法律综合评分改善的影响。达到参与指标的患者在所有领域的改善均显著高于未参与的患者，且对于门诊就诊的患者，酒精和法律结局方面的关系更强。参与治疗者所获得的益处具有统计学意义，但临床意义不大。这些结果补充了文献中关于治疗开始和参与的临床益处的记载。尽管这些发现仅间接支持将HEDIS参与度测量用于其预期目的——在机构或系统层面区分质量——但它们证实了该测量所涵盖的护理过程与重要的患者结局相关。
