Chapko M, Rothman M L, Ehreth J, Hedrick S C, Sullivan J, Erdly W, Cooper S
HSR&D Field Program, VA Medical Center, Seattle, WA.
Med Care. 1993 Sep;31(9 Suppl):SS15-25.
This report presents data collection measures and methods for the evaluation of Adult Day Health Care (ADHC) in the Department of Veterans Affairs (VA). Measures of patient health were survival, the Sickness Impact Profile, self-rated health, the Mini-Mental State Exam, Psychological Distress Scale, Social Support Scale, and Problem Behaviors Scale. Measures of health for the care giver were: Activities of Daily Living, Instrumental Activities of Daily Living, health perceptions, Psychological Distress Scale, life satisfaction, Social Support Scale, and Caregiver Burden Scale. We also assessed patient and care giver satisfaction with the care received by the patient. Measures of health status and outcomes were assessed primarily through patient and care giver interview at study enrollment, 6 months, and 12 months. Utilization and cost both within and outside VA were assessed for hospital, ambulatory care, nursing home, ADHC, home care, pharmacy, laboratory, and other forms of health care. Sources of utilization data included VA's computerized patient database, VA medical records, patient questionnaires, care giver questionnaires, and health care providers outside VA. Costs were obtained from VA's cost accounting system, VA Central Office, VA's contracts with outside providers, and directly from outside providers. Utilization and cost were assessed for each patient for a period of 1 year after entry into the study.
本报告介绍了退伍军人事务部（VA）对成人日间保健（ADHC）进行评估的数据收集措施和方法。患者健康指标包括生存率、疾病影响概况、自评健康状况、简易精神状态检查表、心理困扰量表、社会支持量表和问题行为量表。护理人员的健康指标包括：日常生活活动能力、工具性日常生活活动能力、健康认知、心理困扰量表、生活满意度、社会支持量表和护理人员负担量表。我们还评估了患者和护理人员对患者所接受护理的满意度。健康状况和结果指标主要通过在研究入组时、6个月和12个月时对患者和护理人员进行访谈来评估。对VA内部和外部的医院、门诊护理、疗养院、ADHC、家庭护理、药房、实验室及其他形式医疗保健的利用率和成本进行了评估。利用率数据来源包括VA的计算机化患者数据库、VA医疗记录、患者问卷、护理人员问卷以及VA外部的医疗保健提供者。成本来自VA的成本核算系统、VA中央办公室、VA与外部提供者的合同，以及直接来自外部提供者。在患者进入研究后的1年时间内，对每位患者的利用率和成本进行了评估。
