Outcomes across the care continuum. Home health care.
OBJECTIVE
This article describes one approach to measuring outcomes across the continuum of care.


METHODS
Development and testing of the outcome-based quality-improvement methodology as developed by the University of Colorado Center for Health Services Research in Denver, Colorado are summarized.


RESULTS
Reliable and valid measures for home health care covering end results (pure outcome), intermediate results (instrumental outcome), and use (proxy outcome) were developed and are useful in demonstrating patient improvement or stabilization as well as decline. Further, these measures can be aggregated by agency and, with appropriate severity or risk adjustment, can be used to compare outcomes over time and across agencies.


CONCLUSIONS
National testing of the methodology is currently ongoing, with refinements underway in measures, risk adjustment, and operational implementation.
Shaughnessy
P W
PW
School of Medicine, University of Colorado Health Sciences Center, Denver, USA.
Crisler
K S
KS
Schlenker
R E
RE
Arnold
A G
AG
D003266:Continuity of Patient Care / Q000458:organization & administration / Q000592:standards; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration / Q000592:standards; D005544:Forecasting; D006302:Health Services Research / Q000379:methods*; D006699:Home Care Services / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D006278:Medicare; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010346:Patient Care Management; D011787:Quality of Health Care; D012720:Severity of Illness Index; D014481:United States