VA-NHAP
Assessing the Quality of Preparation for Post-Hospital Care from the Patient's Perspective:
The Care Transitions Measure
Funded by: Robert Wood Johnson Foundation, National Institute on Aging, Paul Beeson Faculty
Scholar in Aging Research/American Federation for Aging Research
Project Period: 5/04 - 12/05
Abstract
Background: Evidence that both quality and patient safety are
jeopardized for patients undergoing transitions across care settings continues to expand.
Performance measurement is one potential strategy for improving the quality of transitional
care. A valid and reliable self-report measure of the quality of care transitions is needed
that is both consistent with the concept of patient-centeredness and useful for the purpose
of performance measurement and quality improvement.
Objective: To develop and test a self-report measure of the quality
of care transitions that captures the patient's perspective and has demonstrated utility for
quality improvement.
Subjects: Patients age 18 years and older discharged from one of
the three hospitals of a vertically integrated health system.
Research Design:Cross-sectional assessment of factor structure,
dimensionality, and construct validity.
Results:The Care Transitions Measure (CTM), a 15-item unidimensional
measure of the quality of preparation for care transitions, was found to have high internal
consistency, reliability, and reflect four focus group-derived content domains. The measure
was shown to discriminate between patients discharged from the hospital who did and did not
have a subsequent emergency department visit or rehospitalization for their index condition.
CTM scores were significantly different between health care facilities known to vary in level
of system integration.
Discussion:The CTM not only provides meaningful, patient-centered
insight into the quality of care transitions, but because of the association between CTM scores
and undesirable utilization outcomes, it also provides information that may be useful to
clinicians, hospital administrators, quality improvement entities, and third party payers.
Key Staff: Coleman, Parry, Chalmers, Kramer, Min, Schoen, Mahoney.
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