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The Relationship between Patient Out...

Lieberz, Dalerie J.

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The Relationship between Patient Outcomes, Healthcare Utilization, and Guideline Adherence with Management of Knee Osteoarthritis.

Record Type:	Electronic resources : Monograph/item
Title/Author:	The Relationship between Patient Outcomes, Healthcare Utilization, and Guideline Adherence with Management of Knee Osteoarthritis./
Author:	Lieberz, Dalerie J.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
Description:	171 p.
Notes:	Source: Dissertations Abstracts International, Volume: 80-11, Section: B.
Contained By:	Dissertations Abstracts International80-11B.
Subject:	Physical therapy. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=13858601
ISBN:	9781392148839

The Relationship between Patient Outcomes, Healthcare Utilization, and Guideline Adherence with Management of Knee Osteoarthritis.
Lieberz, Dalerie J.

The Relationship between Patient Outcomes, Healthcare Utilization, and Guideline Adherence with Management of Knee Osteoarthritis. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 171 p.

Source: Dissertations Abstracts International, Volume: 80-11, Section: B.

Thesis (Ph.D.)--Capella University, 2019.

This item must not be added to any third party search indexes.

Evidence-based practice, such as adherence to clinical practice guidelines (CPG), has been promoted by providers, payors, and researchers to enhance quality. Research related to quality has not been conducted on the relationship between adherence to CPG, the patient reported outcomes, and health care utilization for managing individuals with knee osteoarthritis (OA). This nonexperimental correlational study addressed the following research questions: (a) Do differences in guideline adherence with physical therapy interventions predict the patient reported outcome measured with the Lower Extremity Functional Scale (LEFS)? (b) Do differences in health care utilization (i.e., clinic rurality, number of visits, duration of an episode of care, other nonphysical therapy interventions such as knee injection and use of opioid pain medications) predict the patient reported outcome measured with the LEFS? (c) Do differences in patient characteristics (i.e., age, sex, race, initial LEFS, body mass index [BMI], and presence of other chronic conditions) predict the patient reported outcome measured with the LEFS? A research institute affiliated with a multistate health care organization provided the archival data used for the analysis. Data were collected from electronic health records and included physical therapy interventions provided, pre- and posttreatment LEFS patient outcome scores, health care utilization data, and patient characteristics for patients (N = 731) who had received physical therapy for a medical diagnosis of knee OA from 2014-2018. Most subjects in the data set were female (71.1%), White (97.9%), and ranged in age from 27 to 95 years of age (M = 69, SD = 10.899). Sixty-one percent of the sample received guideline-adherent care; however, there was no significant difference in guideline adherence between the outcome groups (p = .854). The number of physical therapy visits (p = .000) and the duration of the episode of care (p = .004) was a statistically significant difference between the groups. The successful outcome group had a greater number of visits and longer duration of care; however, logistic regression analysis did not show either was predictive of an outcome. The presence of an opioid prescription (p = .000) and higher initial LEFS (p = .000) score was a statistically significant difference between the groups and predictive of an unsuccessful outcome with logistic regression analysis. Further research is needed to clarify the relationship between adherence to CPG, patient outcomes, and health care utilization to optimize health care quality and health policy decision making.

ISBN: 9781392148839Subjects--Topical Terms:

588713
Physical therapy.
Subjects--Index Terms:

Clinical practice guideline

The Relationship between Patient Outcomes, Healthcare Utilization, and Guideline Adherence with Management of Knee Osteoarthritis.
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245 1 4 $a The Relationship between Patient Outcomes, Healthcare Utilization, and Guideline Adherence with Management of Knee Osteoarthritis.
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300 $a 171 p.
500 $a Source: Dissertations Abstracts International, Volume: 80-11, Section: B.
500 $a Publisher info.: Dissertation/Thesis.
500 $a Advisor: Ward, Roger.
502 $a Thesis (Ph.D.)--Capella University, 2019.
506 $a This item must not be added to any third party search indexes.
506 $a This item must not be sold to any third party vendors.
520 $a Evidence-based practice, such as adherence to clinical practice guidelines (CPG), has been promoted by providers, payors, and researchers to enhance quality. Research related to quality has not been conducted on the relationship between adherence to CPG, the patient reported outcomes, and health care utilization for managing individuals with knee osteoarthritis (OA). This nonexperimental correlational study addressed the following research questions: (a) Do differences in guideline adherence with physical therapy interventions predict the patient reported outcome measured with the Lower Extremity Functional Scale (LEFS)? (b) Do differences in health care utilization (i.e., clinic rurality, number of visits, duration of an episode of care, other nonphysical therapy interventions such as knee injection and use of opioid pain medications) predict the patient reported outcome measured with the LEFS? (c) Do differences in patient characteristics (i.e., age, sex, race, initial LEFS, body mass index [BMI], and presence of other chronic conditions) predict the patient reported outcome measured with the LEFS? A research institute affiliated with a multistate health care organization provided the archival data used for the analysis. Data were collected from electronic health records and included physical therapy interventions provided, pre- and posttreatment LEFS patient outcome scores, health care utilization data, and patient characteristics for patients (N = 731) who had received physical therapy for a medical diagnosis of knee OA from 2014-2018. Most subjects in the data set were female (71.1%), White (97.9%), and ranged in age from 27 to 95 years of age (M = 69, SD = 10.899). Sixty-one percent of the sample received guideline-adherent care; however, there was no significant difference in guideline adherence between the outcome groups (p = .854). The number of physical therapy visits (p = .000) and the duration of the episode of care (p = .004) was a statistically significant difference between the groups. The successful outcome group had a greater number of visits and longer duration of care; however, logistic regression analysis did not show either was predictive of an outcome. The presence of an opioid prescription (p = .000) and higher initial LEFS (p = .000) score was a statistically significant difference between the groups and predictive of an unsuccessful outcome with logistic regression analysis. Further research is needed to clarify the relationship between adherence to CPG, patient outcomes, and health care utilization to optimize health care quality and health policy decision making.
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653 $a Health care utilization
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653 $a Patient outcomes
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