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新的医疗复杂性儿童护理协调质量措施的验证。

Validation of New Care Coordination Quality Measures for Children with Medical Complexity.

机构信息

RAND Corporation, Santa Monica, Calif.

RAND Corporation, Santa Monica, Calif.

出版信息

Acad Pediatr. 2018 Jul;18(5):581-588. doi: 10.1016/j.acap.2018.03.006. Epub 2018 Mar 14.

Abstract

OBJECTIVES

To validate new caregiver-reported quality measures assessing care coordination services for children with medical complexity (CMC).

METHODS

A cross-sectional analysis of the associations between 20 newly developed Family Experiences with Coordination of Care (FECC) quality measures and 3 validation measures among 1209 caregivers who responded to a telephone or mailed survey from August to November 2013 in Minnesota and Washington. Validation measures included an access composite, a provider rating item, and a care coordination outcome measure, all derived from Consumer Assessments of Healthcare Providers and Systems (CAHPS) survey items. Multivariate regression was used to examine associations between the 3 validation measures and each of the 20 FECC quality measures.

RESULTS

Nineteen of the 20 FECC quality measures were significantly and positively associated with ≥1 of the validation measures. The components of care coordination demonstrating the strongest positive association with provider ratings included: 1) having a care coordinator who was knowledgeable and supportive and advocated for the child's needs (β = 26.4; 95% confidence interval [CI], 20.0-32.8, scaled to reflect change associated with a 0-100 change in the FECC measure score); and 2) receiving a written visit summary that was useful and easy to understand (β = 22.0; 95% CI, 17.1-27.0).

CONCLUSIONS

Nineteen newly developed FECC quality measures demonstrated convergent validity with previously validated CAHPS measures. These new measures are valid for assessing the quality of care coordination services provided to CMC and may be useful for evaluating new models of care focused on improving these services.

摘要

目的

验证新的照顾者报告的质量措施,评估患有复杂疾病的儿童(CMC)的护理协调服务。

方法

对 20 项新开发的家庭协调体验(FECC)质量措施与 1209 名照顾者的 3 项验证措施之间的关联进行横断面分析,这些照顾者于 2013 年 8 月至 11 月期间通过电话或邮寄调查做出回应,调查地点在明尼苏达州和华盛顿。验证措施包括一个访问综合指标、一个提供者评分项目和一个护理协调结果衡量标准,全部源自医疗保健提供者和系统消费者评估(CAHPS)调查项目。多元回归用于检验 3 项验证措施与 20 项 FECC 质量措施中的每一项之间的关联。

结果

20 项 FECC 质量措施中有 19 项与≥1 项验证措施呈显著正相关。与提供者评分呈最强正相关的护理协调组成部分包括:1)有一个知识渊博、支持和倡导孩子需求的护理协调员(β=26.4;95%置信区间[CI],20.0-32.8,按反映与 FECC 衡量标准得分 0-100 变化相关的变化进行缩放);和 2)收到一份有用且易于理解的书面访问摘要(β=22.0;95% CI,17.1-27.0)。

结论

19 项新开发的 FECC 质量措施与先前经过验证的 CAHPS 措施具有收敛效度。这些新措施可用于评估为 CMC 提供的护理协调服务的质量,并且可能有助于评估专注于改善这些服务的新护理模式。

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