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Quality Outcomes (quality + outcome)
Selected AbstractsThe Association Between Partner Enhancement and Self-Enhancement and Relationship Quality OutcomesJOURNAL OF MARRIAGE AND FAMILY, Issue 3 2009Dean M. Busby The purpose of this research was to understand in greater detail, using 2 samples (Study 1 N = 4,881 heterosexual couples; Study 2 N = 335 heterosexual couples who completed the Relationship Evaluation Questionnaire), how partner or self-enhancement patterns differentially influence relationship outcomes. A multivariate analysis of covariance was conducted comparing 4 outcome measures for different couple types in which individuals rated the partner higher, the same, or lower than they rated themselves on affability. Couples in which both individuals perceived themselves as more affable than the partner experienced poorer results on the relationship outcome measures, whereas couples in which both individuals perceived the partner's personality as more affable than their own experienced more positive relationship outcomes. Additional analyses with structural equation models demonstrated the consistent influence of enhancement measures on relationship outcomes for cross-sectional and longitudinal samples. [source] Understanding clinical trial outcomes: design, analysis, and interpretationDERMATOLOGIC THERAPY, Issue 2 2007Heidi T. Jacobe ABSTRACT:, Outcomes (a variable intended for comparison between groups) are integral to the design, conduct, and data analysis of a clinical trial. They are broadly divided into four categories: physician based, patient reported, economic based, and technology based. Each is used in dermatology to some degree, but no consensus exists as to what type of outcome or degree of validation should be employed. This is problematical because poor quality outcomes or their incorrect use may invalidate the results of a clinical trial. Despite their importance, outcome measures in dermatology receive little attention. The present authors aim to provide an overview of important considerations for outcome measures and a practical approach to their analysis. [source] Predictors of Chain Acquisition among Independent Dialysis FacilitiesHEALTH SERVICES RESEARCH, Issue 2 2010Alyssa S. Pozniak Objective. To determine the predictors of chain acquisition among independent dialysis providers. Data Sources. Retrospective facility-level data combined from CMS Cost Reports, Medical Evidence Forms, Annual Facility Surveys, and claims for 1996,2003. Study Design. Independent dialysis facilities' probability of acquisition by a dialysis chain (overall and by chain size) was estimated using a discrete time hazard rate model, controlling for financial and clinical performance, practice patterns, market factors, and other facility characteristics. Data Collection. The sample includes all U.S. freestanding dialysis facilities that report not being chain affiliated for at least 1 year between 1997 and 2003. Principal Findings. Above-average costs and better quality outcomes are significant determinants of dialysis chain acquisition. Facilities in larger markets were more likely to be acquired by a chain. Furthermore, small dialysis chains have different acquisition strategies than large chains. Conclusions. Dialysis chains appear to employ a mix of turn-around and cream-skimming strategies. Poor financial health is a predictor of chain acquisition as in other health care sectors, but the increased likelihood of chain acquisition among higher quality facilities is unique to the dialysis industry. Significant differences among predictors of acquisition by small and large chains reinforce the importance of using a richer classification for chain status. [source] Definitions of antiretroviral treatment failure for measuring quality outcomesHIV MEDICINE, Issue 7 2010A Samaranayake Objectives Our aim was to compare three different definitions of treatment failure and discuss their use as quality outcome measures for a clinical service. Methods Data for treatment-naïve patients who attended the Melbourne Sexual Health Centre (MSHC) between 1 January 2000 and 31 December 2008 were analysed. Definition 1 was the strict Food and Drug Administration (FDA) definition of treatment failure as determined using the time to loss of virological response (TLOVR) algorithm. Definition 2 defined treatment failure as occurring in those whose viral load never fell to <400 HIV-1 RNA copies/mL or who developed two consecutive viral loads ,400 copies/mL on any treatment (switching or stopping treatment with a viral load <400 copies/mL was permitted). Definition 3 was the same as definition 2 except that individuals were also deemed to have failed if they stopped treatment for 6 months or longer. Results There were 310 antiretroviral-naïve patients who started treatment in the study period. Of these, 156 [50.3%; 95% confidence interval (CI) 42.1,53.3%] experienced treatment failure under definition 1, 10 (3.2%; 95% CI 1.5,5.8%) experienced treatment failure under definition 2, and 16 (4.5%; 95% CI 2.5,7.4%) experienced treatment failure under definition 3 over the 108 months of follow-up. The probability of failing definition 1 was statistically different from the probability of failing definition 2 or 3 (P=0.01). Conclusion There were significant differences in treatment failure for the three definitions. If definition 1 were used, the outcomes would be sufficiently common to enable clinics to be compared but would be less meaningful. If definition 2 or 3 were used, the events would be too rare to enable clinics to be compared, but it would be possible to set a benchmark level of success that clinics could aim to reach. [source] Organizational correlates of perceptions of quality outcomes for ISO 9000 registration: a preliminary analysisQUALITY ASSURANCE JOURNAL, Issue 3 2001Alphonso R. Bellamy Abstract The purpose of this study was to explore the impact that the organizational factors of planning and implementation processes have on individual perceptions of quality outcomes related to The International Organization for Standardization (ISO) 9000 registration. Results indicate that the planning and implementation processes of ISO 9000 registration do indeed have an influence on the ways in which individuals evaluate the impact that registration has on quality outcomes. The study further showed that personality factors also influence perceptual judgments of ISO 9000 registration success. Copyright © 2001 John Wiley & Sons, Ltd. [source] Can we predict recurrence of pre-eclampsia or gestational hypertension?BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2007MA Brown Objective, To estimate the rates of recurrence of pre-eclampsia or gestational hypertension in a subsequent pregnancy and to determine factors predictive of recurrence. Design, Retrospective cohort study. Setting, St George Public and Private Hospitals, teaching hospitals without neonatal intensive care units. Participants, A total of 1515 women with a diagnosis of pre-eclampsia or gestational hypertension between 1988 and 1998 were identified from the St George Hypertension in Pregnancy database, a system designed initially for ensuring quality outcomes of hypertensive pregnancies. Of these, 1354 women were followed up, and a further 333 records from women coded as having a normal pregnancy during that period were selected randomly as controls. Main outcome measures, Likelihood of recurrent pre-eclampsia or gestational hypertension and clinical and routine laboratory factors in the index pregnancy predictive of recurrence of pre-eclampsia or gestational hypertension. Methods, The index cases from our unit's database were linked to the matched pregnancy on the State Department of Health database, allowing us to determine whether further pregnancies had occurred at any hospital in the State. The outcome of these pregnancies was determined by review of medical records, using strict criteria for diagnosis of pre-eclampsia or gestational hypertension. Results, Almost all women with a normal index pregnancy had a further normotensive pregnancy. One in 50 women hypertensive in their index pregnancy had developed essential hypertension by the time of their next pregnancy. Women with pre-eclampsia in their index pregnancy were equally likely to develop either pre-eclampsia or gestational hypertension (approximately 14% each), while women with gestational hypertension were more likely to develop gestational hypertension (26%) rather than pre-eclampsia (6%) in their next pregnancy. Multiparous women with gestational hypertension were more likely than primiparous women to develop pre-eclampsia (11 versus 4%) or gestational hypertension (45 versus 22%) in their next pregnancy. Early gestation at diagnosis in the index pregnancy, multiparity, uric acid levels in the index pregnancy and booking blood pressure parameters in the next pregnancy significantly influenced the likelihood of recurrence, predominantly for gestational hypertension and less so for pre-eclampsia. No value for these parameters was significant enough to be clinically useful as a discriminate value predictive of recurrent pre-eclampsia or gestational hypertension. Conclusions, Approximately 70% of women with pre-eclampsia or gestational hypertension will have a normotensive next pregnancy. The highest risk group for recurrent hypertension in pregnancy in this study was multiparous women with gestational hypertension. No readily available clinical or laboratory factor in the index pregnancy reliably predicts recurrence of pre-eclampsia. [source] Public sector refraction and spectacle dispensing in low-resource countries of the Western PacificCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2008Jacqueline Ramke Abstract Background:, Given that uncorrected refractive error is a frequent cause of vision impairment, and that there is a high unmet need for spectacles, an appraisal of public sector arrangements for the correction of refractive error was conducted in eight Pacific Island countries. Methods:, Mixed methods (questionnaire and semi-structured interviews) were used to collect information from eye care personnel (from Fiji, Papua New Guinea, Solomon Islands, Vanuatu, Cook Islands, Samoa, Tonga and Tuvalu) attending a regional eye health workshop in 2005. Results:, Fiji, Tonga and Vanuatu had Vision 2020 eye care plans that included refraction services, but not spectacle provision. There was wide variation in public sector spectacle dispensing services, but, except in Samoa, ready-made spectacles and a full cost recovery pricing strategy were the mainstay. There were no systems for the registration of personnel, nor guidelines for clinical or systems management. The refraction staff to population ratio varied considerably. Solomon Islands, Tuvalu and Vanuatu had the best coverage by services, either fixed or outreach. Most services had little promotional activity or community engagement. Conclusions:, To be successful, it would seem that public sector refraction services should answer a real and perceived need, fit within prevailing policy and legislation, value, train, retain and equip employees, be well managed, be accessible and affordable, be responsive to consumers, and provide ongoing good quality outcomes. To this end, a checklist to aid the initiation and maintenance of refraction and spectacle systems in low-resource countries has been constructed. 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