title: [External quality assurance in inpatient medical rehabilitation and prevention centers for mothers, fathers and children: comparative outcome quality analyses across rehabilitation/prevention centers].
abstract: To date, there are no programs for external quality assurance for inpatient prevention and rehabilitation programs for mothers, fathers and children. Instruments for outcome quality assessment were evaluated with the goal of determining their ability to document differences between prevention/rehabilitation centers in quality-relevant outcome parameters. Referring to the ICF, relevant outcome variables were specified and operationalized using established questionnaires. Data from 45 inpatient prevention and rehabilitation centers for mothers, fathers and children were analyzed using multilevel modeling with risk adjustment. Intra-class correlations were computed to determine in which parameters differences between institutions could be found. The percentage of variability accounted for by patient vs. institution characteristics was computed while statistically controlling for relevant confounders. For prevention centers, substantial variation on the institutional level was found in 9 out of 15 parameters. Almost all institutions did not deviate significantly from the grand mean of the respective parameter. For rehabilitation centers, significant variability was found in 2 out of 10 parameters. The differences between most institutions remained within a range of expectable variability. The results imply that comparative analyses across hospitals are better suited to identify institutions with low quality rather than establish quality-based rankings of institutions.
authors.affiliation: Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg.
authors.forename: M
authors.initials: M
authors.lastname: Lukasczik
authors.affiliation: Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg.
authors.forename: C
authors.initials: C
authors.lastname: Gerlich
authors.affiliation: Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg.
authors.forename: G
authors.initials: G
authors.lastname: Musekamp
authors.affiliation: Lehrstuhl Arbeit und Berufliche Rehabilitation, Universität zu Köln.
authors.forename: M
authors.initials: M
authors.lastname: Saupe-Heide
authors.affiliation: Fakultät Sozialwesen-Pflegemanagement, Hochschule für Angewandte Wissenschaften, Fachhochschule -Würzburg-Schweinfurt.
authors.forename: R
authors.initials: R
authors.lastname: Löbmann
authors.affiliation: Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg.
authors.forename: H
authors.initials: H
authors.lastname: Vogel
authors.affiliation: Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg.
authors.forename: S
authors.initials: S
authors.lastname: Neuderth
mesh_terms: D000328:Adult; D002648:Child; D002662:Child Health Services / Q000592:standards / Q000706:statistics & numerical data; D005220:Fathers / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000592:standards*; D011314:Preventive Health Services / Q000592:standards* / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D012047:Rehabilitation Centers / Q000592:standards* / Q000706:statistics & numerical data