Gromala T; AcademyHealth. Meeting (2003 : Nashville, Tenn.).

Abstr AcademyHealth Meet. 2003; 20: abstract no. 760.

University of Minnesota, Health Services Research & Policy, PO Box 14784, Minneapolis, MN 55414 Tel. (952) 888-2224 Fax

RESEARCH OBJECTIVE: Identify quality of care differences and patient outcomes delivered to children and adolescents by providers participating within and outside of a quality improvement program in a chiropractic managed care network setting during 1999 and 2000. STUDY DESIGN: This retrospective study uses secondary data from the administrative and clinical databases of a chiropractic managed care network to study the quality of care delivered to children and adolescents receiving chiropractic care through a chiropractic managed care network during 1999 and 2000. The Doctors of Chiropractic (DCs) either participated in the quality improvement program or did not. Univariate and multivariate statistics were used to describe and compare patient care outcomes between the participating and non-participating DC quality improvement groups. POPULATION STUDIED: The population of children and adolescents was stratified by the DCs participation in the quality improvement program. This sample includes children and adolescents who completed care during 1999 (n=2,267) and 2000 (n=4,333). Children (infants through age 10) and adolescents (ages 11 through 17) were studied and stratified by participating quality improvement DCs (75%) and non-participating DCs (25%). PRINCIPAL FINDINGS: The major diagnoses for both groups were similar neuromusculoskeletal problems and injuries. The adolescent group had significantly more injuries and problem severity than the children group. Overall, utilization of care, radiography use, and therapy use was greater for adolescent group. However, the differences were not significant between groups. In this two-year period, rates were similar for both years for children and adolescent groups. Significant differences were found when comparing the children and adolescent groups by DC participating and non-participating in the quality improvement program. Utilization of care, radiography use, therapy use, and treatment length were significantly lower for DCs participating in the quality program compared to the non-participating DCs. Compared to adults and controlling for diagnosis and severity, both children and adolescent groups demonstrated less severe problems and shorter treatment lengths in the quality improvement provider group. Functional outcome data available for children and adolescents groups showed improved scores for patients treated by DCs who participated in the quality improvement program. CONCLUSIONS: The findings suggest that quality improvement programs in the delivery of chiropractic care provide lower process measures such as utilization of care, radiography use, therapy use, and treatment length. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: The quality improvement program offers providers feedback in their delivery of chiropractic care for children and adolescents. Feedback mechanisms give providers opportunities to develop evidence-based practices. Differences in process outcomes are demonstrated. The current incorporation of outcomes measures--pain, function, satisfaction, and health, into the quality improvement program will provide more information on the quality of chiropractic care for children and adolescents.

Publication Types:

• Meeting Abstracts

Keywords:

• Adolescent
• Adult
• Child
• Child Health Services
• Chiropractic
• Health Services Research
• Humans
• Infant
• Managed Care Programs
• Patient Discharge
• Physicians
• Research
• Retrospective Studies
• economics
• utilization
• hsrmtgs

Other ID:

• GWHSR0004049

UI: 102275728

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