5) Ch3: Common Outcomes in Rehabilitation

Question 1

Patient Outcomes

Answer 1

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

Question 2

Functional Outcomes

Answer 2

Measure of the pt’s ability to perform ADL’s, home & work activities, and goal-directed mobility skills following an episode of care

Question 3

Provider Outcomes

Answer 3

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

Question 4

Impairment Outcomes

Answer 4

Measures of changes at the body or tissue level that may occur as a result of interventions (healing processes)

Question 5

Service Outcomes

Answer 5

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

Question 6

Normative Standards

Answer 6

Comparison to the gold standard such as healthy age-matched cohort

Question 7

Relative Standards

Answer 7

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

Question 8

Criterion Reference

Answer 8

Compares pt performance against a criterion reference (task analysis of that activity)

Question 9

QOL

Answer 9

A person’s assessment of satisfaction w/their life

Question 10

HRQOL

Answer 10

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

Question 11

Medical Effectiveness

Answer 11

Extent to which a medical intervention is able to cure a disease/condition

Question 12

Patient Satisfaction

Answer 12

Pt’s perception of the care they have received

Question 13

Service Satisfaction

Answer 13

Pt’s perception of satisfaction from interacting w/a provider

Question 14

Technical Satisfaction

Answer 14

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

Question 15

Humaneness Satisfaction

Answer 15

Pt’s perception of the provider’s warmth, caring, willingness to listen, appropriateness of verbal and nonverbal behavior, and respect

Question 16

Goods Satisfaction

Answer 16

Satisfaction w/a product or item that can be used regardless of where it is produced

Question 17

Access Satisfaction

Answer 17

Perceptions of the convenience for physically accessing care (schedule, the hours, distance, and perceived availability)

Question 18

Atmospherics

Answer 18

Perceptions of the environment in which services are delivered

Question 19

Cost-Effectiveness

Answer 19

Comparison of the cost to produce the same outcome by similar providers or service delivery systems

• Result of delivering care vs delaying care

Question 20

Cost-Benefit

Answer 20

Benefits of providing services relative to the cost or negative aspects of providing the service

Question 21

Cost Utility

Answer 21

Estimate of pt preferences for different health states relative to the length & QOL and available interventions

Question 22

Unit Cost

Answer 22

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)

Question 23

Morbidity

Answer 23

Sick:Well ratio in a community or to the frequency of complications that follows a medical intervention

Question 24

Mortality

Answer 24

Death Rate

Question 25

(Quality-Adjusted Life-Years) QALY

Answer 25

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

Question 26

Quality-Adjusted Time Without Symptoms and Toxicities (Q-TWIST)

Answer 26

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