title: [Development of methods and instruments for external quality assurance in inpatient parent-child rehabilitation and prevention].
abstract: OBJECTIVE
  There so far is no standardized program for external quality assurance in inpatient parent-child prevention and rehabilitation in Germany. Therefore, instruments and methods of external quality assurance were developed and evaluated on behalf of the federal-level health insurance institutions.
  
  
  METHODS
  On the level of structure quality, a modular questionnaire for assessing structural features of rehabilitation/prevention centers, basic and allocation criteria as well as a checklist for visitations were developed. Structural data were collected in a nationwide survey of parent-child prevention and rehabilitation centers. Process and outcome quality data were collected in n=38 centers. Process quality was assessed using multiple methods (process-related structural features, case-related routine documentation, and incident-related patient questionnaires). Outcome quality was measured via patient questionnaires (n=1 799 patients). We used a multi-level modelling approach by adjusting relevant confounders on institutional and patient levels.
  
  
  RESULTS
  The methods, instruments and analyzing procedures developed for measuring quality on the level of structure, processes and outcomes were adjusted in cooperation with all relevant stakeholders. Results are exemplarily presented for all quality assurance tools. For most of the risk-adjusted outcome parameters, we found no significant differences between institutions.
  
  
  CONCLUSIONS
  For the first time, a comprehensive, standardized and generally applicable set of methods and instruments for routine use in comparative quality measurement of inpatient parent-child prevention and rehabilitation is available. However, it should be considered that the very heterogeneous field of family-oriented measures can not be covered entirely by an external quality assurance program. Therefore, methods and instruments have to be adapted continuously to the specifics of this area of health care and to new developments.
authors.affiliation: Arbeitsbereich Rehabilitationswissenschaften, Universität Würzburg. s.neuderth@uni-wuerzburg.de
authors.forename: S
authors.initials: S
authors.lastname: Neuderth
authors.forename: M
authors.initials: M
authors.lastname: Lukasczik
authors.forename: G
authors.initials: G
authors.lastname: Musekamp
authors.forename: C
authors.initials: C
authors.lastname: Gerlich
authors.forename: M
authors.initials: M
authors.lastname: Saupe-Heide
authors.forename: R
authors.initials: R
authors.lastname: Löbmann
authors.forename: H
authors.initials: H
authors.lastname: Vogel
mesh_terms: D000328:Adult; D002648:Child; D002908:Chronic Disease / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation*; D005191:Family Characteristics; D005219:Father-Child Relations; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D009034:Mother-Child Relations; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D010290:Parents / Q000193:education*; D010343:Patient Admission; D017060:Patient Satisfaction; D010865:Pilot Projects; D011602:Psychophysiologic Disorders / Q000523:psychology / Q000534:rehabilitation; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D012047:Rehabilitation Centers / Q000458:organization & administration* / Q000592:standards*; D012216:Rheumatic Diseases / Q000523:psychology / Q000534:rehabilitation; D013001:Somatoform Disorders / Q000523:psychology / Q000534:rehabilitation; D014789:Visitors to Patients