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A randomized trial of two quality improvement strategies implemented in a statewide public community-based, long-term care program.
Kinney, Eleanor D; Kennedy, John; Cook, Cynthia A Loveland; Freedman, Jay A; Lane, Kathleen A; Hui, Siu L.
Afiliación
  • Kinney ED; Center for Law and Health, Indiana University School of Law-Indianapolis, Indianapolis, Indiana 46202, USA. ekinney@iupui.edu
Med Care ; 41(9): 1048-57, 2003 Sep.
Article en En | MEDLINE | ID: mdl-12972844
BACKGROUND: It has not been demonstrated that the implementation of computerized quality improvement strategies can improve client-centered outcomes in public community based, long-term care (CBLTC) programs. OBJECTIVES: To test and evaluate 2 innovative computer-assisted, client-centered quality improvement strategies for public community-based, long-term care. The first strategy, the Normative Treatment Planning (NTP) program, assesses needs, prescribes services, and evaluates outcomes. The second strategy, the Client Feedback System (CFS) program, provides service vendors with feedback on client perceptions of services. RESEARCH DESIGN: A 2 x 2 factorial design with the 2 strategies using cluster randomization. SUBJECTS: A total of 2222 clients (86% of eligible program clients) enrolled in Indiana's state case management program and/or the Medicaid home and community-based services waiver program for the aged and disabled as of January 1, 1995. MEASURES: Outcomes of needs met and client satisfaction were measured through telephone surveys every 6 months for 2 years. RESULTS: A total of 1006 participants (45%) completed the 2-year evaluation study. For the group using only the NTP program, perception of needs met and client satisfaction were significantly better than the control group over the 2 years. During this period, the group using only the CFS program had significantly better client satisfaction than the control group. However, the effect sizes of the significant differences were small, and no statistically significant effects were found for the group using both programs. CONCLUSIONS: Client-centered quality improvement strategies can be implemented to enable public CBLTC programs to meet client needs better and increase client satisfaction.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistemas de Información Administrativa / Cuidados a Largo Plazo / Gestión de la Calidad Total / Servicios de Atención de Salud a Domicilio Tipo de estudio: Clinical_trials / Prognostic_studies Aspecto: Implementation_research Límite: Aged / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Med Care Año: 2003 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistemas de Información Administrativa / Cuidados a Largo Plazo / Gestión de la Calidad Total / Servicios de Atención de Salud a Domicilio Tipo de estudio: Clinical_trials / Prognostic_studies Aspecto: Implementation_research Límite: Aged / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Med Care Año: 2003 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos