HEDIS initiation and engagement quality measures of substance use disorder care: impact of setting and health care specialty.
Identifieur interne : 001770 ( Main/Corpus ); précédent : 001769; suivant : 001771HEDIS initiation and engagement quality measures of substance use disorder care: impact of setting and health care specialty.
Auteurs : Alex H S. Harris ; Thomas Bowe ; John W. Finney ; Keith HumphreysSource :
- Population health management [ 1942-7905 ] ; 2009.
English descriptors
- KwdEn :
- Ambulatory Care Facilities (MeSH), Humans (MeSH), Markov Chains (MeSH), Quality Assurance, Health Care (MeSH), Quality Indicators, Health Care (MeSH), Substance-Related Disorders (diagnosis), Substance-Related Disorders (epidemiology), Substance-Related Disorders (therapy), United States (epidemiology), United States Department of Veterans Affairs (MeSH).
- MESH :
- geographic , epidemiology : United States.
- diagnosis : Substance-Related Disorders.
- epidemiology : Substance-Related Disorders.
- therapy : Substance-Related Disorders.
- Ambulatory Care Facilities, Humans, Markov Chains, Quality Assurance, Health Care, Quality Indicators, Health Care, United States Department of Veterans Affairs.
Abstract
Many health care systems track the HEDIS measures of initiation and engagement in substance use disorder (SUD) care. However, the impact of setting of care (inpatient vs. outpatient) and health care specialty (SUD, psychiatric, other) on the likelihood of patients meeting the initiation and engagement criteria are unknown. If the vast majority of initiation and engagement occurs within SUD specialty clinics, then these quality measures could be used to discriminate among and incentivize SUD clinic managers. However, if these criteria are satisfied in different settings and specialties, then they should be considered characteristics of the entire facility, rather than just specialty SUD units. Using a Markov model, the probabilities of advancing to treatment initiation and engagement given initial setting and specialty of care were estimated for 320,238 SUD-diagnosed Veterans Health Affairs (VA) patients. Patients in SUD specialty units progressed more often (diagnosis to initiation, initiation to engagement) than patients in other specialties. Progression through the criteria differed for inpatients vs. outpatients. Approximately 25% of initiation and over 40% of engagement occurred outside of SUD specialty care. VA patients who have contact with SUD specialty treatment have higher rates of advancing to initiation, and from initiation to engagement, compared to SUD-diagnosed patients in psychiatric or other medical locations. Even so, a substantial portion of initiation and engagement occurs outside of SUD specialty units. Therefore, these quality measures should be considered measures of facility performance rather than measures of the quality of SUD specialty care. The usual combining of inpatient and outpatient performance on these measures into overall facility scores clouds measurement and interpretation.
DOI: 10.1089/pop.2008.0028
PubMed: 19663621
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pubmed:19663621Le document en format XML
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Finney</name></author><author><name sortKey="Humphreys, Keith" sort="Humphreys, Keith" uniqKey="Humphreys K" first="Keith" last="Humphreys">Keith Humphreys</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2009">2009</date><idno type="RBID">pubmed:19663621</idno><idno type="pmid">19663621</idno><idno type="doi">10.1089/pop.2008.0028</idno><idno type="wicri:Area/Main/Corpus">001770</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001770</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">HEDIS initiation and engagement quality measures of substance use disorder care: impact of setting and health care specialty.</title><author><name sortKey="Harris, Alex H S" sort="Harris, Alex H S" uniqKey="Harris A" first="Alex H S" last="Harris">Alex H S. Harris</name><affiliation><nlm:affiliation>VA Center for Health Care Evaluation, 795 Willow Road, Menlo Park, CA 94025, USA. Alexander.Harris2@va.gov</nlm:affiliation></affiliation></author><author><name sortKey="Bowe, Thomas" sort="Bowe, Thomas" uniqKey="Bowe T" first="Thomas" last="Bowe">Thomas Bowe</name></author><author><name sortKey="Finney, John W" sort="Finney, John W" uniqKey="Finney J" first="John W" last="Finney">John W. Finney</name></author><author><name sortKey="Humphreys, Keith" sort="Humphreys, Keith" uniqKey="Humphreys K" first="Keith" last="Humphreys">Keith Humphreys</name></author></analytic><series><title level="j">Population health management</title><idno type="eISSN">1942-7905</idno><imprint><date when="2009" type="published">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ambulatory Care Facilities (MeSH)</term><term>Humans (MeSH)</term><term>Markov Chains (MeSH)</term><term>Quality Assurance, Health Care (MeSH)</term><term>Quality Indicators, Health Care (MeSH)</term><term>Substance-Related Disorders (diagnosis)</term><term>Substance-Related Disorders (epidemiology)</term><term>Substance-Related Disorders (therapy)</term><term>United States (epidemiology)</term><term>United States Department of Veterans Affairs (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>United States</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Substance-Related Disorders</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Substance-Related Disorders</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Substance-Related Disorders</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Ambulatory Care Facilities</term><term>Humans</term><term>Markov Chains</term><term>Quality Assurance, Health Care</term><term>Quality Indicators, Health Care</term><term>United States Department of Veterans Affairs</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Many health care systems track the HEDIS measures of initiation and engagement in substance use disorder (SUD) care. However, the impact of setting of care (inpatient vs. outpatient) and health care specialty (SUD, psychiatric, other) on the likelihood of patients meeting the initiation and engagement criteria are unknown. If the vast majority of initiation and engagement occurs within SUD specialty clinics, then these quality measures could be used to discriminate among and incentivize SUD clinic managers. However, if these criteria are satisfied in different settings and specialties, then they should be considered characteristics of the entire facility, rather than just specialty SUD units. Using a Markov model, the probabilities of advancing to treatment initiation and engagement given initial setting and specialty of care were estimated for 320,238 SUD-diagnosed Veterans Health Affairs (VA) patients. Patients in SUD specialty units progressed more often (diagnosis to initiation, initiation to engagement) than patients in other specialties. Progression through the criteria differed for inpatients vs. outpatients. Approximately 25% of initiation and over 40% of engagement occurred outside of SUD specialty care. VA patients who have contact with SUD specialty treatment have higher rates of advancing to initiation, and from initiation to engagement, compared to SUD-diagnosed patients in psychiatric or other medical locations. Even so, a substantial portion of initiation and engagement occurs outside of SUD specialty units. Therefore, these quality measures should be considered measures of facility performance rather than measures of the quality of SUD specialty care. The usual combining of inpatient and outpatient performance on these measures into overall facility scores clouds measurement and interpretation.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">19663621</PMID><DateCompleted><Year>2009</Year><Month>11</Month><Day>23</Day></DateCompleted><DateRevised><Year>2016</Year><Month>05</Month><Day>11</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1942-7905</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><Issue>4</Issue><PubDate><Year>2009</Year><Month>Aug</Month></PubDate></JournalIssue><Title>Population health management</Title><ISOAbbreviation>Popul Health Manag</ISOAbbreviation></Journal><ArticleTitle>HEDIS initiation and engagement quality measures of substance use disorder care: impact of setting and health care specialty.</ArticleTitle><Pagination><MedlinePgn>191-6</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1089/pop.2008.0028</ELocationID><Abstract><AbstractText>Many health care systems track the HEDIS measures of initiation and engagement in substance use disorder (SUD) care. However, the impact of setting of care (inpatient vs. outpatient) and health care specialty (SUD, psychiatric, other) on the likelihood of patients meeting the initiation and engagement criteria are unknown. If the vast majority of initiation and engagement occurs within SUD specialty clinics, then these quality measures could be used to discriminate among and incentivize SUD clinic managers. However, if these criteria are satisfied in different settings and specialties, then they should be considered characteristics of the entire facility, rather than just specialty SUD units. Using a Markov model, the probabilities of advancing to treatment initiation and engagement given initial setting and specialty of care were estimated for 320,238 SUD-diagnosed Veterans Health Affairs (VA) patients. Patients in SUD specialty units progressed more often (diagnosis to initiation, initiation to engagement) than patients in other specialties. Progression through the criteria differed for inpatients vs. outpatients. Approximately 25% of initiation and over 40% of engagement occurred outside of SUD specialty care. VA patients who have contact with SUD specialty treatment have higher rates of advancing to initiation, and from initiation to engagement, compared to SUD-diagnosed patients in psychiatric or other medical locations. Even so, a substantial portion of initiation and engagement occurs outside of SUD specialty units. Therefore, these quality measures should be considered measures of facility performance rather than measures of the quality of SUD specialty care. The usual combining of inpatient and outpatient performance on these measures into overall facility scores clouds measurement and interpretation.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Harris</LastName><ForeName>Alex H S</ForeName><Initials>AH</Initials><AffiliationInfo><Affiliation>VA Center for Health Care Evaluation, 795 Willow Road, Menlo Park, CA 94025, USA. Alexander.Harris2@va.gov</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bowe</LastName><ForeName>Thomas</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Finney</LastName><ForeName>John W</ForeName><Initials>JW</Initials></Author><Author ValidYN="Y"><LastName>Humphreys</LastName><ForeName>Keith</ForeName><Initials>K</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013486">Research Support, U.S. Gov't, Non-P.H.S.</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Popul Health Manag</MedlineTA><NlmUniqueID>101481266</NlmUniqueID><ISSNLinking>1942-7891</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000554" MajorTopicYN="N">Ambulatory Care Facilities</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008390" MajorTopicYN="N">Markov Chains</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011785" MajorTopicYN="Y">Quality Assurance, Health Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019984" MajorTopicYN="N">Quality Indicators, Health Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019966" MajorTopicYN="N">Substance-Related Disorders</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014481" MajorTopicYN="N" Type="Geographic">United States</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014493" MajorTopicYN="N">United States Department of Veterans Affairs</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2009</Year><Month>8</Month><Day>12</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2009</Year><Month>8</Month><Day>12</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2009</Year><Month>12</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">19663621</ArticleId><ArticleId IdType="doi">10.1089/pop.2008.0028</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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