文章基本信息

标题：Development and Applications of an Outcomes Assessment Framework for Care Management Programs in Learning Health Systems
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作者：Wang, Lin ; Kuntz-Melcavage, Kara ; Forrest, Christopher 等
期刊名称：eGEMs (Generating Evidence & Methods to improve patient outcomes)
印刷版ISSN：2327-9214
出版年度：2015
卷号：3
期号：1
页码：9
出版社：EDM Forum
摘要：Purpose: To develop and apply an outcomes assessment framework (OAF) for care management programs in health care delivery settings. Background: Care management (CM) refers to a regimen of organized activities that are designed to promote health in a population with particular chronic conditions or risk profiles, with focus on the triple aim for populations: improving the quality of care, advancing health outcomes, and lowering health care costs. CM has become an integral part of a care continuum for population-based health care management. To sustain a CM program, it is essential to assure and improve CM effectiveness through rigorous outcomes assessment. To this end, we constructed the OAF as the foundation of a systematic approach to CM outcomes assessment. Innovations: To construct the OAF, we first systematically analyzed the operation process of a CM program; then, based on the operation analysis, we identified causal relationships between interventions and outcomes at various implementation stages of the program. This set of causal relationships established a roadmap for the rest of the outcomes assessment. Built upon knowledge from multiple disciplines, we (1) formalized a systematic approach to CM outcomes assessment, and (2) integrated proven analytics methodologies and industrial best practices into operation-oriented CM outcomes assessment. Conclusion: This systematic approach to OAF for assessing the outcomes of CM programs offers an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings.
关键词：Methods; Comparative Effectiveness; Quality Improvement; 2014 EDM Forum Symposium; Learning Health Systems