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Centre for Policy on Ageing | |
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Using structured implicit review to assess quality of care in the Program of All-inclusive Care for the Elderly (PACE) | Author(s) | James T Pacala, Robert L Kane, Adam J Atherly |
Journal title | Journal of the American Geriatrics Society, vol 48, no 8, August 2000 |
Pages | pp 903-910 |
Keywords | Domiciliary services ; Day services ; Health services ; Coordination ; Management [care] ; Quality ; Evaluation ; United States of America. |
Annotation | Structured implicit review (SIR) has been developed to direct reviewers to use guidelines with the aim of improving the reliability of the assessment, while retaining added validity when compared with explicit criteria review. The researchers developed a quality assessment (QA) programme for the PACE setting using the SIR technique. Medical records of 313 older people at 8 PACE sites were reviewed by trained geriatricians and geriatric nurse practitioners. Overall care quality was judged to be above a community standard in 56% and below standard in 8% of cases. Process of care was rated as very good or good in 70% of cases. Outcomes depended on how questions were phrased. The SIR method produced ratings demonstrating considerable variability across the sites, with 3 showing consistently poorer quality ratings than the other five. Despite significant limitations of poor interrater reliability for process of care measures, excessive time involved for the reviews, and lack of a control group, the SIR method was able to consistently discriminate quality ratings among PACE sites. A modified version of the assessment instrument may prove useful. (RH). |
Accession Number | CPA-001020206 A |
Classmark | N: NM: L: QAJ: QA: 59: 4C: 7T |
Data © Centre for Policy on Ageing |
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...from the Ageinfo database published by Centre for Policy on Ageing. |
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