Are patient ratings of interactions with providers and health plans associated with technical quality of care in systemic lupus erythematosus?
Notice bibliographique
Résumé
Prior research has shown that the technical quality of SLE care is associated with the degree of subsequent accumulated damage. However, it is not known whether the nature of interactions between patients and providers and health systems is associated with the technical quality of care. We analyzed data from the UCSF Lupus Outcomes Study (LOS), a national sample of persons with SLE interviewed annually using a structured telephone survey. The survey includes batteries from the Consumer Assessment of Health Plans developed by the US Agency for Healthcare Research and Quality and the Interpersonal Processes of Care Scales to rate care along six dimensions about providers (patient-provider communication, shared decision-making, and trust) and health systems (promptness/timeliness of care, care coordination, and assessment of health plans) from 0 to 100. Due to the fact that the ratings were not normally distributed, we dichotomized the measures at the lowest versus the highest three quartiles. The survey also includes the 13 quality indicators (QIs) for SLE that can be reliably reported by patients. The QIs were aggregated into a pass rate, defined as the number of QIs received as a proportion of those for which individuals are eligible. We used generalized estimating equations to model the relationship of the QI pass rate with being in the lowest quartile of ratings of each individual dimension and with being in the lowest quartile on zero, one to three, and four to six of the dimensions. Models were adjusted for age, race/ethnicity, education, poverty status, presence and kind of health insurance, specialty of principal SLE physician, disease duration, disease activity (SLAQ), and disease damage (BILD). A total of 640 LOS participants with ≥1 visit to their principal SLE provider in the year prior to interview were eligible for analysis. Mean age was 52.8 ± 12.6 years and mean disease duration was 20.1 ± 8.8 years; 38% were nonwhites, and 14% were in poverty. Being in the lowest quartile of ratings on any one individual dimension was not associated with a statistically significant difference in QI pass rates (data not shown). Being in the lowest quartile of ratings on four to six dimensions was associated with significantly lower pass rates (0.63 vs. 0.71 for those in the lowest quartile on no dimensions, P = 0.02) (Table 1 ). Low ratings on multiple dimensions of interactions may be a sentinel for poor technical quality of care. In the USA, ratings of providers and health plans are in the public domain and this information can help persons with SLE choose providers and health plans more likely to achieve high technical quality of care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».