Measuring pain care quality in the Veterans Health Administration primary care setting

被引：6

作者：

Luther, Stephen L. ^{[1
,2
]}

Finch, Dezon K. ^{[1
]}

Bouayad, Lina ^{[1
,3
]}

McCart, James ^{[1
,4
]}

Han, Ling ^{[5
,7
]}

Dobscha, Steven K. ^{[8
,9
]}

Skanderson, Melissa ^{[6
]}

Fodeh, Samah J. ^{[6
,7
]}

Hahm, Bridget ^{[1
]}

Lee, Allison ^{[5
,10
]}

Goulet, Joseph L. ^{[5
,6
]}

Brandt, Cynthia A. ^{[5
,6
]}

Kerns, Robert D. ^{[5
,10
]}

机构：

[1] James A Haley Vet Hosp, Res & Dev Serv, Mail Code 151R,8900 Grand Oak Circle, Tampa, FL 33637 USA

[2] Univ S Florida, Coll Publ Hlth, Tampa, FL 33620 USA

[3] Florida Int Univ, Miami, FL 33199 USA

[4] Univ S Florida, Morsani Coll Med, Tampa, FL 33620 USA

[5] VA Connecticut Healthcare Syst, Pain Res Informat Multimorbid & Educ Ctr, West Haven, CT USA

[6] Yale Sch Med, Dept Emergency Med, New Haven, CT USA

[7] Yale Sch Med, Dept Internal Med, New Haven, CT USA

[8] VA Portland Hlth Care Syst, Ctr Improve Vet Involvement Care, Portland, OR USA

[9] Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA

[10] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA

来源：

PAIN | 2022年 / 163卷 / 06期

基金：

美国国家卫生研究院;

关键词：

Pain; Quality; Measurement; Natural language processing; RECORD DATA; INFORMATION; MANAGEMENT; IMPLEMENTATION; EXTRACTION; DIAGNOSIS; MODEL;

D O I：

10.1097/j.pain.0000000000002477

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

The lack of a reliable approach to assess quality of pain care hinders quality improvement initiatives. Rule-based natural language processing algorithms were used to extract pain care quality (PCQ) indicators from documents of Veterans Health Administration primary care providers for veterans diagnosed within the past year with musculoskeletal disorders with moderate-to-severe pain intensity across 2 time periods 2013 to 2014 (fiscal year [FY] 2013) and 2017 to 2018 (FY 2017). Patterns of documentation of PCQ indicators for 64,444 veterans and 124,408 unique visits (FY 2013) and 63,427 veterans and 146,507 visits (FY 2017) are described. The most commonly documented PCQ indicators in each cohort were presence of pain, etiology or source, and site of pain (greater than 90% of progress notes), while least commonly documented were sensation, what makes pain better or worse, and pain's impact on function (documented in fewer than 50%). A PCQ indicator score (maximum = 12) was calculated for each visit in FY 2013 (mean = 7.8, SD = 1.9) and FY 2017 (mean = 8.3, SD = 2.3) by adding one point for every indicator documented. Standardized Cronbach alpha for total PCQ scores was 0.74 in the most recent data (FY 2017). The mean PCQ indicator scores across patient characteristics and types of healthcare facilities were highly stable. Estimates of the frequency of documentation of PCQ indicators have face validity and encourage further evaluation of the reliability, validity, and utility of the measure. A reliable measure of PCQ fills an important scientific knowledge and practice gap.

引用

页码：E715 / E724

页数：10

共 33 条

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