Functional status outcomes for assessment of quality in long-term care.
نویسندگان
چکیده
OBJECTIVE Although decline in functional status has been recommended as a quality indicator in long-term care, studies examining its use provide no consensus on which definition of functional status outcome is the most appropriate to use for quality assessment. We examined whether different definitions of decline in functional status affect judgments of quality of care provided in Department of Veterans Affairs (VA) long-term care facilities. METHODS Six measures of functional status outcome that are prominent in the literature were considered. The sample consisted of 15 409 individuals who resided in VA long-term care facilities at any time from 4/1/95 to 10/1/95. Activities of daily living variables were used to generate measures of functional status. Differences between residents' baseline and semi-annual assessments were considered and facility performance using the various definitions of functional status were described. RESULTS The percentage of residents seen as declining in functional status ranged from 7.7% to 31.5%, depending upon the definition applied. The definition of functional status also affected rankings, z-scores, and 'outlier' status for facilities. CONCLUSION Judgments of facility performance are sensitive to how outcome measures are defined. Careful selection of an appropriate definition of functional status outcome is needed when assessing quality in long-term care.
منابع مشابه
Revision Fixation of Distal Humerus Fracture Nonunions in Older Age Patients with Poor Bone Quality or Bone Loss – Is This Viable as a Long-term Treatment Option?
Background: The purpose of this retrospective study was to analyze the long-term results of revision ORIF, jointcontracture release, and autogenous bone-grafting in the treatment of distal humerus frac-ture nonunions in older agedpatients with poor bone quality or bone loss who would have been candidates for total elbow arthroplasty.Methods: Seven patients (average age at inde...
متن کاملCurrent Status of Long-term Care in Taiwan: Transition of Long-term Care Plan From 1.0 to 2.0
متن کامل
The Effect of Prehabilitation on the Self-Reported Outcomes of Anterior Cruciate Ligament Reconstruction: A Systematic Review Running Title:
Background and Purpose: Quadriceps weakness and disruption of proprioceptive function are common after anterior cruciate ligament (ACL) injury and consequently the surgery. Postoperative self-reported outcomes are affected by the preoperative defect. The purpose of this review study was to examine whether preoperative exercises can affect self-reported outcomes. Methods: The study started sear...
متن کاملAging, Pensions and Long-term Care: What, Why, Who, How?; Comment on “Financing Long-term Care: Lessons From Japan”
Japan has been aging faster than other industrialized nations, and its experience offers useful lessons to others. Japan has been willing to expand its welfare state with a long-term care (LTC) insurance to finance home care and nursing home care for frail elderly. As Ikegami shows, it created new facilities and expanded specialized staffing for home care, developed a c...
متن کاملO-14: New Era in Sperm Selection for ICSIProcedure
Background: Intra-cytoplasmic sperm insemination, the ICSI, is considered as the one most routine treatment of male infertility. Although the genetic inheritance of an individual is based on the genetic contribution from both the oocyte and sperm, considering the fact that ICSI by passes all the barriers to natural fertilization much emphasis was given to oocyte quality to improve the ICSI outc...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- International journal for quality in health care : journal of the International Society for Quality in Health Care
دوره 11 1 شماره
صفحات -
تاریخ انتشار 1999