Predictive validity of two process-of-care quality measures for residential substance use disorder treatment
In order to monitor and ultimately improve the quality of addiction treatment, professional societies, health care systems, and addiction treatment programs must establish clinical practice standards and then operationalize these standards into reliable, valid, and feasible quality measures. Before...
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| Veröffentlicht in: | Addiction science & clinical practice 2015-10, Vol.10 (1), p.22-22, Article 22 |
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| creator | Harris, Alex H S Gupta, Shalini Bowe, Thomas Ellerbe, Laura S Phelps, Tyler E Rubinsky, Anna D Finney, John W Asch, Steven M Humphreys, Keith Trafton, Jodie |
| description | In order to monitor and ultimately improve the quality of addiction treatment, professional societies, health care systems, and addiction treatment programs must establish clinical practice standards and then operationalize these standards into reliable, valid, and feasible quality measures. Before being implemented, quality measures should undergo tests of validity, including predictive validity. Predictive validity refers to the association between process-of-care quality measures and subsequent patient outcomes. This study evaluated the predictive validity of two process quality measures of residential substance use disorder (SUD) treatment.
Washington Circle (WC) Continuity of Care quality measure is the proportion of patients having an outpatient SUD treatment encounter within 14 days after discharge from residential SUD treatment. The Early Discharge measure is the proportion of patients admitted to residential SUD treatment who discharged within 1 week of admission. The predictive validity of these process measures was evaluated in US Veterans Health Administration patients for whom utilization-based outcome and 2-year mortality data were available. Propensity score-weighted, mixed effects regression adjusted for pre-index imbalances between patients who did and did not meet the measures' criteria and clustering of patients within facilities.
For the WC Continuity of Care measure, 76 % of 10,064 patients had a follow-up visit within 14 days of discharge. In propensity score-weighted models, patients who had a follow-up visit had a lower 2-year mortality rate [odds ratio (OR) = 0.77, p = 0.008], but no difference in subsequent detoxification episodes relative to patients without a follow-up visit. For the Early Discharge measure, 9.6 % of 10,176 discharged early and had significantly higher 2-year mortality (OR = 1.49, p |
| doi_str_mv | 10.1186/s13722-015-0042-5 |
| format | Article |
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Washington Circle (WC) Continuity of Care quality measure is the proportion of patients having an outpatient SUD treatment encounter within 14 days after discharge from residential SUD treatment. The Early Discharge measure is the proportion of patients admitted to residential SUD treatment who discharged within 1 week of admission. The predictive validity of these process measures was evaluated in US Veterans Health Administration patients for whom utilization-based outcome and 2-year mortality data were available. Propensity score-weighted, mixed effects regression adjusted for pre-index imbalances between patients who did and did not meet the measures' criteria and clustering of patients within facilities.
For the WC Continuity of Care measure, 76 % of 10,064 patients had a follow-up visit within 14 days of discharge. In propensity score-weighted models, patients who had a follow-up visit had a lower 2-year mortality rate [odds ratio (OR) = 0.77, p = 0.008], but no difference in subsequent detoxification episodes relative to patients without a follow-up visit. For the Early Discharge measure, 9.6 % of 10,176 discharged early and had significantly higher 2-year mortality (OR = 1.49, p < 0.001) and more subsequent detoxification episodes.
These two measures of residential SUD treatment quality have strong associations with 2-year mortality and the Early Discharge measure is also associated with more subsequent detoxification episodes. These results provide initial support for the predictive validity of residential SUD treatment quality measures and represent the first time that any SUD quality measure has been shown to predict subsequent mortality.</description><identifier>ISSN: 1940-0640</identifier><identifier>ISSN: 1940-0632</identifier><identifier>EISSN: 1940-0640</identifier><identifier>DOI: 10.1186/s13722-015-0042-5</identifier><identifier>PMID: 26520402</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Addictions ; Adult ; Analysis ; Care and treatment ; Continuity of Patient Care - organization & administration ; Detoxification (Substance abuse treatment) ; Female ; Health care reform ; Health services ; Humans ; Male ; Measurement ; Medical care ; Medical research ; Medicine, Experimental ; Mental health ; Middle Aged ; Mortality ; Outcome and Process Assessment (Health Care) - organization & administration ; Patient Discharge ; Patients ; Propensity Score ; Quality Indicators, Health Care - standards ; Quality management ; Quality of Health Care - organization & administration ; Reproducibility of Results ; Residential Treatment - standards ; Severity of Illness Index ; Substance abuse ; Substance abuse treatment ; Substance Abuse Treatment Centers - standards ; United States ; United States Department of Veterans Affairs ; Veterans</subject><ispartof>Addiction science & clinical practice, 2015-10, Vol.10 (1), p.22-22, Article 22</ispartof><rights>COPYRIGHT 2015 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2015</rights><rights>Harris et al. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-dfc118e07384cd2c6deb4dc7849ba9cc0fc5d58f33266f1c785cc721fdae5ffe3</citedby><cites>FETCH-LOGICAL-c525t-dfc118e07384cd2c6deb4dc7849ba9cc0fc5d58f33266f1c785cc721fdae5ffe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672518/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672518/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,12846,27924,27925,30999,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26520402$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harris, Alex H S</creatorcontrib><creatorcontrib>Gupta, Shalini</creatorcontrib><creatorcontrib>Bowe, Thomas</creatorcontrib><creatorcontrib>Ellerbe, Laura S</creatorcontrib><creatorcontrib>Phelps, Tyler E</creatorcontrib><creatorcontrib>Rubinsky, Anna D</creatorcontrib><creatorcontrib>Finney, John W</creatorcontrib><creatorcontrib>Asch, Steven M</creatorcontrib><creatorcontrib>Humphreys, Keith</creatorcontrib><creatorcontrib>Trafton, Jodie</creatorcontrib><title>Predictive validity of two process-of-care quality measures for residential substance use disorder treatment</title><title>Addiction science & clinical practice</title><addtitle>Addict Sci Clin Pract</addtitle><description>In order to monitor and ultimately improve the quality of addiction treatment, professional societies, health care systems, and addiction treatment programs must establish clinical practice standards and then operationalize these standards into reliable, valid, and feasible quality measures. Before being implemented, quality measures should undergo tests of validity, including predictive validity. Predictive validity refers to the association between process-of-care quality measures and subsequent patient outcomes. This study evaluated the predictive validity of two process quality measures of residential substance use disorder (SUD) treatment.
Washington Circle (WC) Continuity of Care quality measure is the proportion of patients having an outpatient SUD treatment encounter within 14 days after discharge from residential SUD treatment. The Early Discharge measure is the proportion of patients admitted to residential SUD treatment who discharged within 1 week of admission. The predictive validity of these process measures was evaluated in US Veterans Health Administration patients for whom utilization-based outcome and 2-year mortality data were available. Propensity score-weighted, mixed effects regression adjusted for pre-index imbalances between patients who did and did not meet the measures' criteria and clustering of patients within facilities.
For the WC Continuity of Care measure, 76 % of 10,064 patients had a follow-up visit within 14 days of discharge. In propensity score-weighted models, patients who had a follow-up visit had a lower 2-year mortality rate [odds ratio (OR) = 0.77, p = 0.008], but no difference in subsequent detoxification episodes relative to patients without a follow-up visit. For the Early Discharge measure, 9.6 % of 10,176 discharged early and had significantly higher 2-year mortality (OR = 1.49, p < 0.001) and more subsequent detoxification episodes.
These two measures of residential SUD treatment quality have strong associations with 2-year mortality and the Early Discharge measure is also associated with more subsequent detoxification episodes. These results provide initial support for the predictive validity of residential SUD treatment quality measures and represent the first time that any SUD quality measure has been shown to predict subsequent mortality.</description><subject>Addictions</subject><subject>Adult</subject><subject>Analysis</subject><subject>Care and treatment</subject><subject>Continuity of Patient Care - organization & administration</subject><subject>Detoxification (Substance abuse treatment)</subject><subject>Female</subject><subject>Health care reform</subject><subject>Health services</subject><subject>Humans</subject><subject>Male</subject><subject>Measurement</subject><subject>Medical care</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Outcome and Process Assessment (Health Care) - organization & administration</subject><subject>Patient Discharge</subject><subject>Patients</subject><subject>Propensity Score</subject><subject>Quality Indicators, Health Care - standards</subject><subject>Quality management</subject><subject>Quality of Health Care - organization & administration</subject><subject>Reproducibility of Results</subject><subject>Residential Treatment - standards</subject><subject>Severity of Illness Index</subject><subject>Substance abuse</subject><subject>Substance abuse treatment</subject><subject>Substance Abuse Treatment Centers - standards</subject><subject>United States</subject><subject>United States Department of Veterans Affairs</subject><subject>Veterans</subject><issn>1940-0640</issn><issn>1940-0632</issn><issn>1940-0640</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNptkl9rVDEQxS-i2Fr9AL5IQJC-3JrkJvfPi1CKVaGgD_ocssmkm5J7s80kK_32ZtladkXyMCHzO2eYcJrmLaMXjI39R2TdwHlLmWwpFbyVz5pTNgna0l7Q5wf3k-YV4h2lvZzk-LI54b3kVFB-2oQfCaw32W-BbHXw1ucHEh3JvyPZpGgAsY2uNToBuS8VqO0ZNJYESFxMpFZvYcleB4JlhVkvBkhBINZjTBYSyQl0nivzunnhdEB481jPml_Xn39efW1vvn_5dnV50xrJZW6tM3U9oEM3CmO56S2shDXDKKaVnoyhzkgrR9d1vO8dqw1pzMCZsxqkc9CdNZ_2vpuymsGaOjrpoDbJzzo9qKi9Ou4sfq1u41aJfuCSjdXg_NEgxfsCmNXs0UAIeoFYULGBT52YupFV9P0_6F0saanrVWrgVA6yO6BudQDlFxfrXLMzVZdi2G3KOa_UxX-oeizM3sQFnK_vR4IPB4I16JDXGEPJPi54DLI9aFJETOCePoNRtcuS2mdJ1SypXZaUrJp3h7_4pPgbnu4PvU7GDg</recordid><startdate>20151031</startdate><enddate>20151031</enddate><creator>Harris, Alex H S</creator><creator>Gupta, Shalini</creator><creator>Bowe, Thomas</creator><creator>Ellerbe, Laura S</creator><creator>Phelps, Tyler E</creator><creator>Rubinsky, Anna D</creator><creator>Finney, John W</creator><creator>Asch, Steven M</creator><creator>Humphreys, Keith</creator><creator>Trafton, Jodie</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QJ</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20151031</creationdate><title>Predictive validity of two process-of-care quality measures for residential substance use disorder treatment</title><author>Harris, Alex H S ; Gupta, Shalini ; Bowe, Thomas ; Ellerbe, Laura S ; Phelps, Tyler E ; Rubinsky, Anna D ; Finney, John W ; Asch, Steven M ; Humphreys, Keith ; Trafton, Jodie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-dfc118e07384cd2c6deb4dc7849ba9cc0fc5d58f33266f1c785cc721fdae5ffe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Addictions</topic><topic>Adult</topic><topic>Analysis</topic><topic>Care and treatment</topic><topic>Continuity of Patient Care - organization & administration</topic><topic>Detoxification (Substance abuse treatment)</topic><topic>Female</topic><topic>Health care reform</topic><topic>Health services</topic><topic>Humans</topic><topic>Male</topic><topic>Measurement</topic><topic>Medical care</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Mental health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Outcome and Process Assessment (Health Care) - organization & administration</topic><topic>Patient Discharge</topic><topic>Patients</topic><topic>Propensity Score</topic><topic>Quality Indicators, Health Care - standards</topic><topic>Quality management</topic><topic>Quality of Health Care - organization & administration</topic><topic>Reproducibility of Results</topic><topic>Residential Treatment - standards</topic><topic>Severity of Illness Index</topic><topic>Substance abuse</topic><topic>Substance abuse treatment</topic><topic>Substance Abuse Treatment Centers - standards</topic><topic>United States</topic><topic>United States Department of Veterans Affairs</topic><topic>Veterans</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harris, Alex H S</creatorcontrib><creatorcontrib>Gupta, Shalini</creatorcontrib><creatorcontrib>Bowe, Thomas</creatorcontrib><creatorcontrib>Ellerbe, Laura S</creatorcontrib><creatorcontrib>Phelps, Tyler E</creatorcontrib><creatorcontrib>Rubinsky, Anna D</creatorcontrib><creatorcontrib>Finney, John W</creatorcontrib><creatorcontrib>Asch, Steven M</creatorcontrib><creatorcontrib>Humphreys, Keith</creatorcontrib><creatorcontrib>Trafton, Jodie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Addiction science & clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harris, Alex H S</au><au>Gupta, Shalini</au><au>Bowe, Thomas</au><au>Ellerbe, Laura S</au><au>Phelps, Tyler E</au><au>Rubinsky, Anna D</au><au>Finney, John W</au><au>Asch, Steven M</au><au>Humphreys, Keith</au><au>Trafton, Jodie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive validity of two process-of-care quality measures for residential substance use disorder treatment</atitle><jtitle>Addiction science & clinical practice</jtitle><addtitle>Addict Sci Clin Pract</addtitle><date>2015-10-31</date><risdate>2015</risdate><volume>10</volume><issue>1</issue><spage>22</spage><epage>22</epage><pages>22-22</pages><artnum>22</artnum><issn>1940-0640</issn><issn>1940-0632</issn><eissn>1940-0640</eissn><abstract>In order to monitor and ultimately improve the quality of addiction treatment, professional societies, health care systems, and addiction treatment programs must establish clinical practice standards and then operationalize these standards into reliable, valid, and feasible quality measures. Before being implemented, quality measures should undergo tests of validity, including predictive validity. Predictive validity refers to the association between process-of-care quality measures and subsequent patient outcomes. This study evaluated the predictive validity of two process quality measures of residential substance use disorder (SUD) treatment.
Washington Circle (WC) Continuity of Care quality measure is the proportion of patients having an outpatient SUD treatment encounter within 14 days after discharge from residential SUD treatment. The Early Discharge measure is the proportion of patients admitted to residential SUD treatment who discharged within 1 week of admission. The predictive validity of these process measures was evaluated in US Veterans Health Administration patients for whom utilization-based outcome and 2-year mortality data were available. Propensity score-weighted, mixed effects regression adjusted for pre-index imbalances between patients who did and did not meet the measures' criteria and clustering of patients within facilities.
For the WC Continuity of Care measure, 76 % of 10,064 patients had a follow-up visit within 14 days of discharge. In propensity score-weighted models, patients who had a follow-up visit had a lower 2-year mortality rate [odds ratio (OR) = 0.77, p = 0.008], but no difference in subsequent detoxification episodes relative to patients without a follow-up visit. For the Early Discharge measure, 9.6 % of 10,176 discharged early and had significantly higher 2-year mortality (OR = 1.49, p < 0.001) and more subsequent detoxification episodes.
These two measures of residential SUD treatment quality have strong associations with 2-year mortality and the Early Discharge measure is also associated with more subsequent detoxification episodes. These results provide initial support for the predictive validity of residential SUD treatment quality measures and represent the first time that any SUD quality measure has been shown to predict subsequent mortality.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>26520402</pmid><doi>10.1186/s13722-015-0042-5</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Addictions Adult Analysis Care and treatment Continuity of Patient Care - organization & administration Detoxification (Substance abuse treatment) Female Health care reform Health services Humans Male Measurement Medical care Medical research Medicine, Experimental Mental health Middle Aged Mortality Outcome and Process Assessment (Health Care) - organization & administration Patient Discharge Patients Propensity Score Quality Indicators, Health Care - standards Quality management Quality of Health Care - organization & administration Reproducibility of Results Residential Treatment - standards Severity of Illness Index Substance abuse Substance abuse treatment Substance Abuse Treatment Centers - standards United States United States Department of Veterans Affairs Veterans |
| title | Predictive validity of two process-of-care quality measures for residential substance use disorder treatment |
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