[Development of outcome indicators of urinary incontinence for quality evaluation in long term care hospitals].
OBJECTIVE
To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea.


METHODS
The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals.


RESULTS
The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month.


CONCLUSIONS
This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.
Yoon
Ju Young
JY
School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
Lee
Ji Yun
JY
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006299:Health Services for the Aged / Q000592:standards; D006761:Hospitals; D006801:Humans; D008134:Long-Term Care / Q000592:standards*; D008297:Male; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011787:Quality of Health Care; D014549:Urinary Incontinence / Q000628:therapy*