Hittle David F, Shaughnessy Peter W, Crisler Kathryn S, Powell Martha C, Richard Angela A, Conway Karin S, Stearns Paula M, Engle Karen
a Center for Health Services Research (CHSR), University of Colorado Health Sciences Center , Denver , CO E-mail:
b Center for Health Services Research (CHSR), University of Colorado Health Sciences Center , Denver , CO E-mail:
Home Health Care Serv Q. 2004 Feb 2;22(4):43-63. doi: 10.1300/J027v22n04_03.
The Outcome and Assessment Information Set (OASIS) is used for outcome reporting, quality improvement, and case mix adjustment of per-episode payment for home health care. The research described here addresses interrater reliability of OASIS items and compares clinician time required to complete patient assessment with and without OASIS. Interrater reliability for OASIS data items was estimated using independent assessments by two clinicians for a sample of 66 patients. Incremental assessment time due to OASIS was estimated using interview data from two agency-matched groups of clinical care providers-one group who used OASIS in the assessment and a second group whose assessment did not include OASIS items. Interrater reliability is excellent (kappa > .80) for many OASIS items and substantial (kappa > 0.60) for most items. The reported time required to complete an assessment with OASIS did not differ from the time required for a comparable assessment without OASIS. The results of this study are being used to guide developmental efforts to improve OASIS items. They can also be informative to home health care agencies when interpreting OASIS-based outcome and case mix reports.
结果与评估信息集（OASIS）用于家庭医疗保健的结果报告、质量改进以及按次付费的病例组合调整。此处所述研究探讨了OASIS项目的评分者间信度，并比较了使用和不使用OASIS时临床医生完成患者评估所需的时间。通过两名临床医生对66名患者样本进行独立评估，估算了OASIS数据项目的评分者间信度。利用来自两个机构匹配的临床护理提供者组的访谈数据，估算了因OASIS导致的额外评估时间——一组在评估中使用OASIS，另一组的评估不包括OASIS项目。许多OASIS项目的评分者间信度极佳（kappa>.80），大多数项目的信度较高（kappa>0.60）。报告显示，使用OASIS完成评估所需的时间与不使用OASIS进行类似评估所需的时间没有差异。本研究结果正用于指导改进OASIS项目的开发工作。在解读基于OASIS的结果和病例组合报告时，这些结果对家庭医疗保健机构也具有参考价值。
