Back to Search
Start Over
Effect of Physician Delegation to Other Healthcare Providers on the Quality of Care for Geriatric Conditions.
- Source :
- Journal of the American Geriatrics Society; Oct2015, Vol. 63 Issue 10, p2164-2170, 7p, 2 Charts
- Publication Year :
- 2015
-
Abstract
- The quality of care of older adults in the United States has been consistently shown to be inadequate. This gap between recommended and actual care provides an opportunity to improve the value of health care for older adults. Prior work from the Assessing Care of Vulnerable Elders ( ACOVE) investigators first defined, and then sought to improve, clinical practice for common geriatric conditions. A critical component of the ACOVE intervention for practice improvement was an emphasis on the delegation of specific care processes, but the independent effect of delegation on the quality of care has not been evaluated. This study analyzed the pooled results of prior ACOVE projects from 1998 to 2010. Totaled, these studies included 4,776 individuals aged 65 and older of mixed demographic backgrounds and 16,204 ACOVE quality indicators ( QIs) for three geriatric conditions: falls, urinary incontinence, and dementia. In unadjusted analyses, QI pass probabilities were 0.36 for physician-performed tasks, 0.55 for nurse practitioner ( NP)-, physician assistant ( PA)-, and registered nurse ( RN)-performed tasks; and 0.61 for medical assistant- and licensed vocational nurse-performed tasks. In multiply adjusted models, the independent pass-probability effect of delegation to NPs, PAs, and RNs was 1.37 ( P = .05). These findings suggest that delegation of selected tasks to nonphysician healthcare providers is associated with higher quality of care for these geriatric conditions in community practices and supports the value of interdisciplinary team management for common outpatient conditions in older adults. [ABSTRACT FROM AUTHOR]
- Subjects :
- CLINICAL medicine
COGNITION disorders in old age
CONFIDENCE intervals
STATISTICAL correlation
DELEGATION of authority
DEMENTIA
ACCIDENTAL falls in old age
GERIATRICS
MEDICAL assistants
MEDICAL quality control
MULTIVARIATE analysis
NURSE practitioners
NURSES
PHYSICIANS' assistants
POISSON distribution
PROBABILITY theory
REGRESSION analysis
RESEARCH funding
STATISTICS
DATA analysis
KEY performance indicators (Management)
DATA analysis software
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 00028614
- Volume :
- 63
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 110425617
- Full Text :
- https://doi.org/10.1111/jgs.13654