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Important Outcome Measure (important + outcome_measure)
Selected AbstractsOverall self-rated health: a new quality indicator for primary careJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2007James E. Rohrer PhD Abstract Rationale, aims and objectives, Patient ,empowerment' gives patients choices about their own care and about the outcomes they would most prefer. Many patients can be presumed to regard overall self-rated health as an important outcome. Therefore, overall self-rated health can be considered a relevant and important outcome measure for a patient-centred medical clinic. The purpose of this study was to use this new outcome measure as a dependent variable and to test the hypothesis that patients who are confident about their ability to manage their health will have better health, in comparison to more dependent patients. Methods, We conducted a randomized cross-sectional postal survey of 500 veteran patients from the Panhandle of Texas and the surrounding areas; and 302 participated in the study. Multiple logistic regression analysis was used to test the hypothesis that health confidence is positively related to self-rated health, controlling for obesity, cigarette smoking and participation in recreational activities. Results, Veterans who strongly disagreed with the statement that they usually could overcome illnesses on their own were less likely to report good, very good or excellent self-rated health (adjusted odds ratio = 0.25). Conclusions, Overall self-rated health as measured by a single question proved to be significantly related to behavioural risk factors in this sample of primary care patients, attesting to its validity as an outcome indicator. Furthermore, health confidence was associated with better health. Most primary providers believe that they can, through good communication and providing self-care tools, increase healthy behaviours in their patients. If we are indeed able to increase health confidence in our patients, this study would suggest that self-rated health would improve. [source] An evaluation of a GP out-of-hours service: meeting patient expectations of careJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2004Kate Thompson MSc Abstract Background, The reorganized out-of-hours general practitioner (GP) service, resulting in the creation of out-of-hours cooperatives has been widely welcomed by the medical profession. However, GP satisfaction remains only one aspect of this reorganized service and patients' views and levels of satisfaction must have a contribution to make to the organization and delivery of the service. Aim, To assess patient satisfaction at two out-of-hours cooperatives in Northern Ireland. Method, A sample of 4466 patients contacting the out-of-hours service was surveyed by postal questionnaires using a previously validated patient satisfaction instrument. Results, Patients who initially requested to be seen at the out-of-hours centre were more likely to receive the contact they requested than those who requested telephone advice or a home visit. Only 41.8% of patients requesting a home visit actually received one. Patients were generally satisfied with the service provided and most satisfied with the ,doctor's manner' and the ,explanation and advice' received. Patients who received the contact they initially requested were more satisfied with all aspects of the service than other patients. The type of contact actually received had little effect on the satisfaction levels reported by patients who received the contact they initially requested. Conclusion, The population should be made fully aware of the services provided by out-of-hours cooperatives to enable them to have realistic expectations. With realistic expectations, patients are more likely to receive the medical contact they request and consequently will be more satisfied with the service provided. High satisfaction level is an important outcome measure of any out-of-hours service as it increases patient confidence and compliance and ultimately clinical outcome. [source] Assessing quality of life in paediatric clinical practiceJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2010Angela M Morrow The rising prevalence of children with chronic conditions has made quality of life an increasingly important outcome measure in paediatric practice. The discrepancy between doctors' and patients' perceptions of quality of life makes formal assessment necessary. In this paper we use a case scenario to answer commonly asked questions. What is quality of life and who can assess it? Why assess quality of life in the clinical setting? Is it feasible to measure in routine clinical practice? How is quality of life formally assessed? We provide a basic outline of the language and methods of quality of life assessment and use the case scenario to discuss the process of choosing an appropriate instrument. We conclude that quality of life assessment in clinical practice is feasible and provides benefits for both patients and doctors. The benefits include better informed doctors, improved patient doctor communication and a means to effectively monitor quality of life as a treatment outcome. [source] Patient and caregiver quality of life in Huntington's diseaseMOVEMENT DISORDERS, Issue 5 2008Rebecca E. Ready PhD Abstract Little is known about subjective perceptions of quality of life (QOL) in Huntington's disease (HD). The current study determined correlates of patient and caregiver QOL and assessed change over time. Participants were 22 patient-caregiver dyads, who rated QOL at baseline and 6 months later. Overall, patients' functional and cognitive impairment were significantly correlated with patient and caregiver QOL. Neuropsychiatric symptoms had differential impact on patient and caregiver QOL. Furthermore, when patients recalled their QOL about a previous time, their recall may have been negatively biased. Clinical implications of results are discussed. Future work is needed because subjective QOL is an important outcome measure in therapeutic trials. © 2008 Movement Disorder Society [source] Quality of life in depression: An important outcome measure in an outpatient cognitive,behavioural therapy group programme?CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 6 2009Amanda Swan Studies have shown that psychiatric patients have significantly impaired quality of life (QOL) in comparison to community samples who are not suffering a mental illness. Despite an increase in research in the mental health field, there still remains little consensus as to the merit of using such questionnaires within a mental health population. There is a concern that QOL is redundant with affective state and symptomatology. We investigated the usefulness of the Quality of Life Enjoyment and Satisfaction Questionnaire-short form (QLESQ-SF) in a depressed outpatient sample receiving time-limited, standardized group cognitive,behavioural therapy. QLESQ-SF ratings were examined at admission and 10-week endpoint in an intention-to-treat (N = 212) and completers (N = 164) sample. QLESQ-SF ratings and symptom ratings (Beck Depression Inventory-II; Beck Anxiety Inventory) improved significantly over time. Hierarchical regression analyses revealed that, although affective state and change in symptomatology were significantly correlated with QOL and change in QOL, a large proportion of variance was unexplained. These results are inconsistent with the theory of measurement redundancy. QOL appears to be a useful measure that provides additional treatment outcome information distinct from affective state and symptomatology.,Copyright © 2009 John Wiley & Sons, Ltd. [source] Decreasing Lab Turnaround Time Improves Emergency Department Throughput and Decreases Emergency Medical Services Diversion: A Simulation ModelACADEMIC EMERGENCY MEDICINE, Issue 11 2008Alan B. Storrow MD Abstract Background:, The effect of decreasing lab turnaround times on emergency department (ED) efficiency can be estimated through system-level simulation models and help identify important outcome measures to study prospectively. Furthermore, such models may suggest the advantage of bedside or point-of-care testing and how they might affect efficiency measures. Objectives:, The authors used a sophisticated simulation model in place at an adult urban ED with an annual census of 55,000 patient visits. The effect of decreasing turnaround times on emergency medical services (EMS) diversion, ED patient throughput, and total ED length of stay (LOS) was determined. Methods:, Data were generated by using system dynamics analytic modeling and simulation approach on 90 separate days from December 2, 2007, through February 29, 2008. The model was a continuous simulation of ED flow, driven by real-time actual patient data, and had intrinsic error checking to assume reasonable goodness-of-fit. A return of complete laboratory results incrementally at 120, 100, 80, 60, 40, 20, and 10 minutes was compared. Diversion calculation assumed EMS closure when more than 10 patients were in the waiting room and 100% ED bed occupancy had been reached for longer than 30 minutes, as per local practice. LOS was generated from data insertion into the patient flow stream and calculation of time to specific predefined gates. The average accuracy of four separate measurement channels (waiting room volume, ED census, inpatient admit stream, and ED discharge stream), all across 24 hours, was measured by comparing the area under the simulated curve against the area under the measured curve. Each channel's accuracy was summed and averaged for an overall accuracy rating. Results:, As lab turnaround time decreased from 120 to 10 minutes, the total number of diversion days (maximum 57 at 120 minutes, minimum 29 at 10 minutes), average diversion hours per day (10.8 hours vs. 6.0 hours), percentage of days with diversion (63% vs. 32%), and average ED LOS (2.77 hours vs. 2.17 hours) incrementally decreased, while average daily throughput (104 patients vs. 120 patients) increased. All runs were at least 85% accurate. Conclusions:, This simulation model suggests compelling improvement in ED efficiency with decreasing lab turnaround time. Outcomes such as time on EMS diversion, ED LOS, and ED throughput represent important but understudied areas that should be evaluated prospectively. EDs should consider processes that will improve turnaround time, such as point-of-care testing, to obtain these goals. [source] | ||||||||||