[Study of a health indicator to assess effectiveness of a hospital outpatient department (author's transl)].
Evaluation of medical cares effectiveness needs health indices allowing the description of the severity of the disease and of the capacity of change. Disability seems a concept adapted to both challenges. It represents a disfunctional state continuum of which the levels are measurable, whatever the etiology or the diagnosis are. It also measures the variation of daily activities reduction, consequence of health disorders. From this concept, the authors have built, and applied to rheumatic patients seen at an outpatient department of gerontology, a seven levels scale. 480 consultations affecting 270 patients were carried out. The mean restriction of disability, at the time of the first referral was 2,9. The indice seems to be valid because it allows to classify the patients in 3 groups according to the severity of the involving disorder. The observed changes for 4 typical disorder groups agreed with what was expected. 122 patients were seen twice or more. The average of the difference between the grading of disability at the time of the first and the last consultation was--0,43, showing a significant improvement. After discussion of some shortcomings of their indice, the authors concluded that the scale used seems adapted to assess effectiveness of outpatient medical cares.
D000203:Activities of Daily Living; D000368:Aged; D000553:Ambulatory Care / Q000592:standards*; D004185:Disability Evaluation; D004526:Efficiency; D005260:Female; D006801:Humans; D008297:Male; D010044:Outpatient Clinics, Hospital; D010297:Paris; D011787:Quality of Health Care; D012216:Rheumatic Diseases / Q000534:rehabilitation*
Etude d'un indicateur de santé destiné à l'évaluation de l'efficacité d'une consultation externe hospitalière (application aux consultants de rhumatologie).