Gromala T; AcademyHealth. Meeting (2003 : Nashville, Tenn.).
Abstr AcademyHealth Meet. 2003; 20: abstract no. 761.
University of Minnesota, Health Services Research & Policy, PO Box 14784, Minneapoolis, MN 55414 Tel. (952) 888-2224 Fax
RESEARCH OBJECTIVE: Identify quality of care differences and patient outcomes delivered to elderly (65+ years) patients 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 elderly patients receiving chiropractic care 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 represents over 6,000 elderly chiropractic patients in Minnesota. They were stratified by the DCs participation in the quality improvement program. The sample includes elderly patients who completed care during 1999 and 2000. Elderly chiropractic patients were studied and stratified by participating quality improvement DCs (75%) and non-participating DCs (25%). PRINCIPAL FINDINGS: Most chief complaints of elderly patients are of neuromusculoskeletal origin and have chronic histories. Regional low back pain and neck pain were most common. The majority of procedures include chiropractic adjustments and manipulation, followed by specific supportive therapies and education. Controlling for similar conditions, the length of care resulted in a slightly longer, but not significant, length of care than for patients from 40 to 64 years of age. Elderly patients reported very high patient satisfaction, compared to young ages (18-39) and middle-aged (40-64) patients. Improved function and reduced pain were found for the primary diagnoses of elderly patients. Finally, elderly patients who saw providers participating in the quality improvement program reported better outcomes and patient satisfaction compared to providers not in the program. This study provides descriptive data and preliminary norms for elderly chiropractic patients. CONCLUSIONS: Elderly patients seen by providers in the chiropractic quality improvement programs had better outcomes and were more satisfied with their care. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: The quality improvement program offers providers feedback in their delivery of chiropractic care for the elderly. 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 the elderly.
Publication Types:
Keywords:
- Aged
- Chiropractic
- Educational Status
- Humans
- Low Back Pain
- Manipulation, Chiropractic
- Minnesota
- Neck Pain
- Pain
- Pain Clinics
- Pain Measurement
- Patient Satisfaction
- Retrospective Studies
- hsrmtgs
Other ID:
UI: 102275729
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