Benchmarking Outpatient Rehabilitation Clinics Using Functional Status Outcomes.

Objective: To utilize functional status (FS) outcomes to benchmark outpatient therapy clinics.Data Sources: Outpatient therapy data from clinics using Focus on Therapeutic Outcomes (FOTO) assessments.Study Design: Retrospective analysis of 538 clinics, involving 2,040 therapists and 90,392 patients...

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Publicado en:Health Services Research Vol. 51; no. 2; pp. 768 - 790
Autores principales: Gozalo, Pedro L., Resnik, Linda J., Silver, Benjamin
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Apr2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2016
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/1475-6773.12344
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        atl: Benchmarking Outpatient Rehabilitation Clinics Using Functional Status Outcomes.
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        au:
          Gozalo, Pedro L.
          Resnik, Linda J.
          Silver, Benjamin
        affil: Center for Gerontology and Health Care Research, School of Public Health, Brown University, Providence RI
      sug:
        subj:
          Outcome Assessment Methods
          Physical Therapy Standards
          Rehabilitation Centers Standards
          Outcome Assessment Standards
          Benchmarking Standards
          Aged, 80 and Over
          Middle Age
          Aged
          Sex Factors
          Reproducibility of Results
          Age Factors
          Adult
          Young Adult
          Length of Stay
          Quality of Health Care
          Retrospective Design
          Female
          Male
          Adolescence
          Human
          Aged, 80 & over
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
          Adolescent: 13-18 years
          Female
          Male
      ab: Objective: To utilize functional status (FS) outcomes to benchmark outpatient therapy clinics.Data Sources: Outpatient therapy data from clinics using Focus on Therapeutic Outcomes (FOTO) assessments.Study Design: Retrospective analysis of 538 clinics, involving 2,040 therapists and 90,392 patients admitted July 2006-June 2008. FS at discharge was modeled using hierarchical regression methods with patients nested within therapists within clinics. Separate models were estimated for all patients, for those with lumbar, and for those with shoulder impairments. All models risk-adjusted for intake FS, age, gender, onset, surgery count, functional comorbidity index, fear-avoidance level, and payer type. Inverse probability weighting adjusted for censoring.Data Collection Methods: Functional status was captured using computer adaptive testing at intake and at discharge.Principal Findings: Clinic and therapist effects explained 11.6 percent of variation in FS. Clinics ranked in the lowest quartile had significantly different outcomes than those in the highest quartile (p < .01). Clinics ranked similarly in lumbar and shoulder impairments (correlation = 0.54), but some clinics ranked in the highest quintile for one condition and in the lowest for the other.Conclusions: Benchmarking models based on validated FS measures clearly separated high-quality from low-quality clinics, and they could be used to inform value-based-payment policies.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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