Affiliation:
1. From the School of Nursing, University of Pennsylvania, Philadelphia, Pa. Dr Lee is currently affiliated with the School of Nursing, Oregon Health Sciences University, Portland, Ore.
Abstract
Background—
Comparing disease management programs and their effects is difficult because of wide variability in program intensity and complexity. The purpose of this effort was to develop an instrument that can be used to describe the intensity and complexity of heart failure (HF) disease management programs.
Methods and Results—
Specific composition criteria were taken from the American Heart Association (AHA) taxonomy of disease management and hierarchically scored to allow users to describe the intensity and complexity of the domains and subdomains of HF disease management programs. The HF Disease Management Scoring Instrument (HF-DMSI) incorporates 6 of the 8 domains from the taxonomy: recipient, intervention content, delivery personnel, method of communication, intensity/complexity, and environment. The 3 intervention content subdomains (education/counseling, medication management, and peer support) are described separately. In this first test of the HF-DMSI, overall intensity (measured as duration) and complexity were rated using an ordinal scoring system. Possible scores reflect a clinical rationale and differ by category, with zero given only if the element could potentially be missing (eg, surveillance by remote monitoring). Content validity was evident as the instrument matches the existing AHA taxonomy. After revision and refinement, 2 authors obtained an inter-rater reliability intraclass correlation coefficient score of 0.918 (confidence interval, 0.880 to 0.944,
P
<0.001) in their rating of 12 studies. The areas with most variability among programs were delivery personnel and method of communication.
Conclusions—
The HF-DMSI is useful for describing the intensity and complexity of HF disease management programs.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Reference28 articles.
1. Partnership for Solutions. Chronic Conditions: Making the Case for Ongoing Care. September 2004. Available at: http://www.partnershipforsolutions.org/. Accessed June 21 2009.
2. Medicare and Chronic Conditions
3. Disease Management Association of America. Definition of disease management. Disease Management Association of America [website]. Available at: http://www.dmaa.org/phi_definition.asp. Accessed April 28 2009.
4. Effectiveness of follow-up booster sessions in improving physical status after cardiac rehabilitation: health, behavioral, and clinical outcomes
5. A Taxonomy for Disease Management
Cited by
29 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献