5) Ch3: Common Outcomes in Rehabilitation Flashcards
Patient Outcomes
Changes in the consequences of illness or injury that occur as a result of interventions that are meaningful to the pt
- Include changes in fxn, social roles, frequency of sx reoccurrence, and occurrence of complications
Functional Outcomes
Measure of the pt’s ability to perform ADL’s, home & work activities, and goal-directed mobility skills following an episode of care
Provider Outcomes
Describe the efficiency, effectiveness, and satisfaction of the PT
- Includes items that can be measured about the clinician such as service consistency, intervention effectiveness, the percentage of satisfied pt’s, service cost per provider, provider satisfaction, and knowledge
Impairment Outcomes
Measures of changes at the body or tissue level that may occur as a result of interventions (healing processes)
Service Outcomes
Assess the overall effect of delivering services to pt’s; Results of the delivery of services w/in an institution, among similar institutions, or across larger health-care systems; Basis for benchmarking
- Reference point could be administrators or accreditation groups
- Include overall pt satisfaction (not always accurate for a number of reasons), utilization of procedures, variability in care, service costs, profits per dx, staff retention and access, reimbursement patterns, referral rates, accreditation status, and comparisons of similar variables w/other types of health-care systems
Normative Standards
Comparison to the gold standard such as healthy age-matched cohort
Relative Standards
Uses pt’s as their own measure of success; PT compares the pt’s perception of what is acceptable to their current abilities/fxnl status
- Goal-attainment scaling
Criterion Reference
Compares pt performance against a criterion reference (task analysis of that activity)
QOL
A person’s assessment of satisfaction w/their life
HRQOL
Multidimensional assessment of life satisfaction as it relates to the pt’s state of health and societal expectations
- Collected via survey
- 3 categories of assessment scales:
- General Health Profiles
- Disease-Specific Scales
- Scale Batteries
Medical Effectiveness
Extent to which a medical intervention is able to cure a disease/condition
Patient Satisfaction
Pt’s perception of the care they have received
Service Satisfaction
Pt’s perception of satisfaction from interacting w/a provider
Technical Satisfaction
Pt’s perceptions that the provider is knowledgeable and able to perform the necessary exam, evals, and tx’s in a comfortable and efficient manner
Humaneness Satisfaction
Pt’s perception of the provider’s warmth, caring, willingness to listen, appropriateness of verbal and nonverbal behavior, and respect
Goods Satisfaction
Satisfaction w/a product or item that can be used regardless of where it is produced
Access Satisfaction
Perceptions of the convenience for physically accessing care (schedule, the hours, distance, and perceived availability)
Atmospherics
Perceptions of the environment in which services are delivered
Cost-Effectiveness
Comparison of the cost to produce the same outcome by similar providers or service delivery systems
- Result of delivering care vs delaying care
Cost-Benefit
Benefits of providing services relative to the cost or negative aspects of providing the service
Cost Utility
Estimate of pt preferences for different health states relative to the length & QOL and available interventions
Unit Cost
Cost to produce/deliver one unit of a product or service; Incorporates both direct and indirect costs of production
- May refer to a single tx, single period spent w/pt, or a single pt-day or time (OP)
Morbidity
Sick:Well ratio in a community or to the frequency of complications that follows a medical intervention
Mortality
Death Rate
(Quality-Adjusted Life-Years) QALY
Assessment of duration of life weighted against the pt’s quality of life
- Prevalent in the literature when there are >2 distinct strategies for tx’ing a condition that has a known px to compare tx’s
- Determined by measuring HRQOL at specific time intervals where an intervention was performed
Quality-Adjusted Time Without Symptoms and Toxicities (Q-TWIST)
Quality-adjusted survival analysis where the pt’s estimated survival time is adjusted based on their experienced QOL
- Can be used to help pt’s w/terminal illnesses choose between methods of management → Consider trade-offs/side-effects
