Peer review of the quality of care : Reliability and sources of variability for outcome and process assessments.
Context. - Peer assessments have traditionally been used to judge the quality of care, but a major drawback has been poor interrater reliability.
- To compare the interrater reliability for outcome and process assessments in a population of frail older adults and to identify systematic sources of variability that contribute to poor reliability.
- Eight sites participating in a managed care program that integrates acute and long-term care for frail older adults.
- A total of 313 frail older adults.
- Retrospective review of the medical record with 180 charts randomly assigned to 2 geriatricians, 2 geriatric nurse practitioners, or 1 geriatrician and 1 geriatric nurse practitioner and 133 charts randomly assigned to either a geriatrician or a geriatric nurse practitioner.
Main Outcome Measures
- lnterrater reliabilities for structured implicit judgments about process and outcomes for overall care and care for each of 8 tracer conditions (eg, arthritis).
- Outcome measures had higher interrater reliability than process measures.
Five outcome measures achieved fair to good reliability (more than 0.40), while none of the process measures achieved reliabilities more than 0.40. (...)
Mots-clés Pascal : Qualité, Soin, Evaluation, Fiabilité, Accord interjuge, Variabilité, Vieillard, Homme
Mots-clés Pascal anglais : Quality, Care, Evaluation, Reliability, Interrater agreement, Variability, Elderly, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0033504
Code Inist : 002B30A03B. Création : 17/04/1998.