scholarly journals Construction and Performance of the Hospice Care Index Claims-Based Quality Measure

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 62-63
Author(s):  
Michael Plotzke ◽  
Thomas Christian ◽  
Kim Groover ◽  
Zinnia Harrison ◽  
Ihsan Abdur-Rahman ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Hospice Care ◽  
Healthcare Providers ◽  
Fee For Service ◽  
Policy Makers ◽  
Provision Of Services ◽  
Hospice Patient ◽  
And Performance ◽  
Consumer Assessment ◽  
Care Index

Abstract As part of the Medicare Hospice Benefit (MHB), hospices submit claims containing information that allows policy makers to assess hospice quality, help policy makers improve the MHB, and increase patients’ experiences of care. We examine ten different hospice quality indicators related to the provision of services and patterns of live discharge. We calculated indicators using 100% Medicare fee-for-service (FFS) claims from October 1, 2018 through September 30, 2019. A hospice’s total score among all ten indicators is referred to as their Hospice Care Index (HCI), with a possible high score of 10. We examined all hospices with at least 20 discharges. After exclusion, we examined 4,155 hospices representing 1,562,003 beneficiaries. Most hospices earn a high HCI score: over 85% of hospices had scores of eight or more. At the same time, there were some lower scoring hospices: one in ten hospices scored seven on the index, and the remaining 4.9% scored six or lower. We find that on average hospices with higher HCI scores have better Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice ratings. Among hospices with a score of ten, 85.1% of caregivers reported they would definitely recommend the hospice vs. 82.9% of caregivers of patients receiving treatment from hospices with a score of seven or less. Using the HCI, the Centers for Medicare and Medicaid Services and hospice patient caregivers can assess hospices across a broad set of indicators. Policymakers and hospices should monitor these ten indicators to understand their performance relative to peers.

scholarly journals Quality indicators for knee and hip osteoarthritis care: a systematic review

RMD Open ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e001590
Author(s):  
Ilgin G Arslan ◽  
Rianne M Rozendaal ◽  
Marienke van Middelkoop ◽  
Saskia A G Stitzinger ◽  
Maarten-Paul Van de Kerkhove ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Narrative Analysis ◽  
Evidence Synthesis ◽  
Prospective Trial ◽  
Healthcare Providers ◽  
Hip Osteoarthritis ◽  
Healthcare Setting ◽  
Process Of Care ◽  
Policy Makers ◽  
Healthcare Settings

To provide an overview of quality indicators (QIs) for knee and hip osteoarthritis (KHOA) care and to highlight differences in healthcare settings. A database search was conducted in MEDLINE (PubMed), EMBASE, CINAHL, Web of Science, Cochrane CENTRAL and Google Scholar, OpenGrey and Prospective Trial Register, up to March 2020. Studies developing or adapting existing QI(s) for patients with osteoarthritis were eligible for inclusion. Included studies were categorised into healthcare settings. QIs from included studies were categorised into structure, process and outcome of care. Within these categories, QIs were grouped into themes (eg, physical therapy). A narrative synthesis was used to describe differences and similarities between healthcare settings. We included 20 studies with a total of 196 QIs mostly related to the process of care in different healthcare settings. Few studies included patients’ perspectives. Rigorous methods for evidence synthesis to develop QIs were rarely used. Narrative analysis showed differences in QIs between healthcare settings with regard to exercise therapy, weight counselling, referral to laboratory tests and ‘do not do’ QIs. Differences within the same healthcare setting were identified on radiographic assessment. The heterogeneity in QIs emphasise the necessity to carefully select QIs for KHOA depending on the healthcare setting. This review provides an overview of QIs outlined to their healthcare settings to support healthcare providers and policy makers in selecting the contextually appropriate QIs to validly monitor the quality of KHOA care. We strongly recommend to review QIs against the most recent guidelines before implementing them into practice.

Colorectal cancer survivors’ surveillance patterns and experiences of care: A SEER-CAHPS study.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 229-229
Author(s):  
Michelle A Mollica ◽  
Lindsey Enewold ◽  
Lisa M Lines ◽  
Michael T. Halpern ◽  
Jessica R. Schumacher ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Resection ◽  
Healthcare Providers ◽  
Ct Imaging ◽  
Fee For Service ◽  
Office Visits ◽  
Specialist Doctor ◽  
Personal Doctor ◽  
History Of ◽  
Consumer Assessment

229 Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer, generally treated with surgical resection, followed by complex surveillance for recurrence. We examined associations between experiences of care and adherence to surveillance Medicare fee-for-service beneficiaries with a history of CRC. Methods: Using linked data from the National Cancer Institute Surveillance Epidemiology and End Results (SEER) cancer registry program, Medicare claims and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience surveys (SEER-CAHPS), we identified survivors ages 65+, diagnosed with local/regional first primary colorectal cancer 1999-2009 who underwent surgical resection and completed CAHPS survey within 36 months of diagnosis. Adherence to guidelines for a three-year observation period was defined as receiving a colonoscopy; at least 2 carcinoembryonic antigen (CEA) tests; and more than 2 office visits and 1 computer tomography (CT) imaging test each year. We dichotomized CAHPS ratings into 9 or 10 out of 10 versus 0-9 for analysis (higher ratings mean better quality). Results: Most of the 314 participants reported ratings of 9 or 10 for overall care (55%), personal doctor (59%), and health plan (60%). Slightly less than half (47%) gave their specialist doctor ratings of 9 or 10. Adherence to surveillance was 76% for office visits, 36.9% for CEA testing, 48.1% for colonoscopy, and 10.3% for CT Imaging. Sixty-two percent of the sample were categorized as adherent (receiving ≥ 2 surveillance guidelines). In multivariable models, adherence to office visits was positively associated with ratings of personal doctor (OR = 2.0; 95% CI = 1.1, 3.5) and specialist doctor (OR = 2.7; 95% CI = 1.4, 4.9), and overall adherence was associated with ratings of personal doctor (OR = 2.1; 95% CI = 1.2, 3.6). Conclusions: Findings point to the important role of patient-provider relationships in adherence to CRC post-resection surveillance guidelines. As adherence to surveillance may increase survival among CRC survivors, further investigation is needed to identify specific components of this relationship, as well as other potential modifiable drivers of surveillance guidelines.

scholarly journals Comparing the Quality of Health Care Providers

2000 ◽  
Vol 3 (1) ◽  
Author(s):  
Mark McClellan ◽  
Douglas Staiger
Keyword(s):  
Quality Indicators ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Care Providers ◽  
Policy Makers ◽  
New Approach ◽  
Provider Quality ◽  
Alternative Measures

This article introduces a new approach for evaluating the quality of healthcare providers, including an integrated solution to several problems that limit the usefulness of available methods. Our approach combines information from all the quality indicators available for a provider (e.g., from other years, other patients, or other indicators for the same patients) to estimate more accurately the provider’s previous or expected quality. The approach also provides an empirical basis for comparing and combining alternative quality indicators, thereby enabling policy makers to choose among potential indicators, explore the potential bias in alternative measures, and increase the value of quality measures for assessing and improving care. Using hospital care for elderly heart attack patients as an example, we demonstrate that these methods can be used to create reliable, precise predictions about provider quality. Comparing quality of care across providers may be far more feasible than many now believe.

scholarly journals Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry

2021 ◽  
Author(s):  
Marjolein Bonthuis ◽  
Enrico Vidal ◽  
Anna Bjerre ◽  
Özlem Aydoğ ◽  
Sergey Baiko ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Cox Regression ◽  
Patient Survival ◽  
Healthcare Providers ◽  
Resource Planning ◽  
Policy Makers ◽  
Age Related ◽  
Kidney Replacement Therapy ◽  
Over Time ◽  
Related Population

Abstract Background For 10 consecutive years, the ESPN/ERA-EDTA Registry has included data on children with stage 5 chronic kidney disease (CKD 5) receiving kidney replacement therapy (KRT) in Europe. We examined trends in incidence and prevalence of KRT and patient survival. Methods We included all children aged <15 years starting KRT 2007–2016 in 22 European countries participating in the ESPN/ERA-EDTA Registry since 2007. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age-related population (pmarp) and time trends studied with JoinPoint regression. We analyzed survival trends using Cox regression. Results Incidence of children commencing KRT <15 years remained stable over the study period, varying between 5.5 and 6.6 pmarp. Incidence by treatment modality was unchanged over time: 2.0 for hemodialysis (HD) and peritoneal dialysis (PD) and 1.0 for transplantation. Prevalence increased in all age categories and overall rose 2% annually from 26.4 pmarp in 2007 to 32.1 pmarp in 2016. Kidney transplantation prevalence increased 5.1% annually 2007–2009, followed by 1.5% increase/year until 2016. Prevalence of PD steadily increased 1.4% per year over the entire period, and HD prevalence started increasing 6.1% per year from 2011 onwards. Five-year unadjusted patient survival on KRT was around 94% and similar for those initiating KRT 2007–2009 or 2010–2012 (adjusted HR: 0.98, 95% CI:0.71–1.35). Conclusions We found a stable incidence and increasing prevalence of European children on KRT 2007–2016. Five-year patient survival was good and was unchanged over time. These data can inform patients and healthcare providers and aid health policy makers on future resource planning of pediatric KRT in Europe.

scholarly journals Predictors of poor health and functional recovery following road trauma: protocol of a British Columbian inception cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049623
Author(s):  
Leona K Shum ◽  
Herbert Chan ◽  
Shannon Erdelyi ◽  
Lulu X Pei ◽  
Jeffrey R Brubacher
Keyword(s):  
Resource Use ◽  
Healthcare Resource ◽  
Healthcare Providers ◽  
Healthcare Resource Use ◽  
Physical And Mental Health ◽  
Inception Cohort ◽  
Policy Makers ◽  
Productivity Costs ◽  
Poor Outcome ◽  
Lost Productivity

IntroductionRoad trauma (RT) is a major public health problem affecting physical and mental health, and may result in prolonged absenteeism from work or study. It is important for healthcare providers to know which RT survivors are at risk of a poor outcome, and policy-makers should know the associated costs. Unfortunately, outcome after RT is poorly understood, especially for RT survivors who are treated and released from an emergency department (ED) without the need for hospital admission. Currently, there is almost no research on risk factors for a poor outcome among RT survivors. This study will use current Canadian data to address these knowledge gaps.Methods and analysisWe will follow an inception cohort of 1500 RT survivors (16 years and older) who visited a participating ED within 24 hours of the accident. Baseline interviews determine pre-existing health and functional status, and other potential risk factors for a poor outcome. Follow-up interviews at 2, 4, 6, and 12 months (key stages of recovery) use standardised health-related quality of life tools to determine physical and mental health outcome, functional recovery, and healthcare resource use and lost productivity costs.Ethics and disseminationThe Road Trauma Outcome Study is approved by our institutional Research Ethics Board. This study aims to provide healthcare providers with knowledge on how quickly RT survivors recover from their injuries and who may be more likely to have a poor outcome. We anticipate that this information will be used to improve management of all road users following RT. Healthcare resource use and lost productivity costs will be collected to provide a better cost estimate of the effects of RT. This information can be used by policy-makers to make informed decisions on RT prevention programmes.

scholarly journals Overlap of Pain and Depression Among Nursing Home Residents With Advanced Alzheimer’s Disease and Related Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 42-43
Author(s):  
Emmanuelle Belanger ◽  
Richard Jones ◽  
Gary Epstein-Lubow ◽  
Kate Lapane
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Hospice Care ◽  
Care Delivery ◽  
Nursing Home Residents ◽  
National Sample ◽  
Fee For Service ◽  
Minimum Dataset

Abstract Physical and psychological suffering are interrelated and should be assessed together as part of palliative care delivery. We aimed to describe the overlap of pain and depressive symptoms among long-stay nursing home (NH) residents with advanced Alzheimer’s disease and related dementia (ADRD), and to determine the incidence of pain and depressive symptoms. We conducted a retrospective study of a US national sample of fee-for-Service Medicare beneficiaries who became long-stay NH residents in 2014-2015, had two consecutive quarterly Minimum Dataset assessments (90 and 180 days +/- 30 days), and had a diagnosis of ADRD in the Chronic Condition Warehouse and moderate to severe cognitive impairment (N= 92,682). We used descriptive statistics and Poisson regression models to examine the incidence of each symptom controlling for age, sex, and concurrent hospice care. Sub-groups with self-reported and observer-rated symptoms (pain/PHQ-9) were modelled separately, as were those switching between the two. The prevalence of depressive symptoms was low (5.7%), while pain was more common (18.2%). Across various subgroups, 2% to 4% had both pain and depression, but between 20% and 25% were treated with both antidepressants and scheduled analgesia. Depressed residents at baseline had an incidence rate ratio (IRR) of pain of 1.2 at the second assessment, while the residents with pain at baseline had an IRR of depressive symptoms of 1.3 at the second assessment. Our results support the expected relationship between pain and depressive symptoms in a national sample of long-stay NH residents with advanced ADRD, suggesting the need for simultaneous clinical management.

scholarly journals Translation, Cross-Cultural Adaptation, and Validation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) into the Malay Language

2019 ◽  
Vol 16 (11) ◽  
pp. 2054 ◽  
Author(s):  
Ahmad Badruridzwanullah Zun ◽  
Mohd Ismail Ibrahim ◽  
Ariffin Marzuki Mokhtar ◽  
Ahmad Sukari Halim ◽  
Wan Nor Arifin Wan Mansor
Keyword(s):  
Healthcare Providers ◽  
The United States ◽  
Patient Perceptions ◽  
Face Validity ◽  
System Quality ◽  
Validity Index ◽  
Hospital Consumer Assessment ◽  
Discharged Patients ◽  
Consumer Assessment ◽  
Face Validation

Background: Patient feedback is an important tool in assessing health system quality. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was developed in 2006 as a standardized instrument to assess patient perceptions in the United States of America. This study aimed to translate and validate the HCAHPS questionnaire into the Malay language in order to assess patient perceptions of health services in Malaysia. Methods: The original HCAPHS in English was translated into Malay based on the established guideline. The content validation involved an expert panel of 10 members, including patients. The face validation pilot testing of the HCAHPS-Malay version was conducted among 10 discharged patients. The exploratory factor analysis (EFA) used principal axis factor, and varimax rotation was established based on a cross-sectional study conducted among 200 discharged patients from Hospital Universiti Sains Malaysia (Hospital USM). Results: The overall content validity index was 0.87, and the universal face validity index was 0.82. From the EFA, the factor loading value ranged from 0.652 to 0.961 within nine domains. The internal consistency reliability with Cronbach’s alpha was 0.844. Conclusion: The HCAHPS-Malay is a reliable and valid tool to determine patients’ perception of healthcare services among inpatients in Hospital USM based on the content and face validation result together with a good construct validity and excellent absolute reliability. Further testing on HCAHPS-Malay version in other settings in Malaysia needs to be done for cross-validation.

Non-R&D Innovation Patterns in Chinese SMEs: An Empirical Study from Zhejiang Province

2016 ◽  
Vol 13 (06) ◽  
pp. 1640014
Author(s):  
Gang Zheng ◽  
Yanting Guo ◽  
Yajuan Wang
Keyword(s):  
Organizational Innovation ◽  
Zhejiang Province ◽  
Policy Makers ◽  
Marketing Innovation ◽  
Innovation Activities ◽  
Use Of Resources ◽  
And Performance ◽  
Innovation Patterns ◽  
Policy Incentives

During the last few decades, research and development (R&D) have always been regarded as the most important or even the only factor in the attempt to explain the innovation capability and performance of enterprises, industries and economies, while to a large extent, those heterogeneous innovation activities beyond formal R&D are ignored or underestimated. Some research has shown that non-R&D innovation activities contribute to make full use of resources beyond R&D to promote performance, especially to small- and medium-sized enterprises (SMEs) with weak R&D capability. However, non-R&D innovators’ behavior is still a black box by far, and especially few empirical research have been conducted in China context. This paper first explores the heterogeneous innovation patterns of non-R&D innovation by survey among Chinese SMEs in Zhejiang Province. It shows that, product and service customization, imitation and design, technology adoption and incremental modification, organizational innovation and marketing innovation are the main patterns of non-R&D innovation in China. Then, a case study is followed to cross-validate the patterns and relationships between non-R&D innovation and growth of SMEs in China. Generally, this study has implications for both academia and policy-makers. As it demonstrates, non-R&D innovation is an effective way for SMEs to quickly grow and sustain competitiveness in competition. On the other hand, this study helps to optimize some of current innovation policies for SMEs in China, where policy incentives are mainly R&D-focused. It also likely sheds light on the SMEs in other emerging economies.

Strategies for Implementing the National Standards for Culturally and Linguistically Appropriate Services in Home Health Care

2017 ◽  
Vol 29 (3) ◽  
pp. 168-175 ◽  
Author(s):  
Mary Curry Narayan
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Healthcare Providers ◽  
Home Health ◽  
National Standards ◽  
Sixth Edition ◽  
Health Care Consumer ◽  
Equitable Outcomes ◽  
Consumer Assessment ◽  
Linguistically Appropriate

This article is an abridged version of a book chapter, Culturally and Linguistically Appropriate Services, published in the Handbook of Home Health Care Administration, Sixth Edition (Marilyn Harris, editor). The article describes the importance of culturally and linguistically competent care for the success of home health agencies. It uses the 15 standards of the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS Standards) as an outline for identifying strategies that home health leaders can incorporate into their agencies’ practices to enhance their care to culturally and linguistically diverse patients. Providing services that produce equitable outcomes for diverse patients is likely to enhance agency Home Health Compare and HHCAHPS (Home Health Care Consumer Assessment of Healthcare Providers and Systems) scores, Star Ratings, and reimbursement in a value-based reimbursement model.

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