Setting Priorities for Measures of Performance for Geriatric Medical Services

University of Southampton, Southampton, England, United Kingdom
Age and Ageing (Impact Factor: 3.64). 04/1994; 23(2):154-7. DOI: 10.1093/ageing/23.2.154
Source: PubMed


We undertook a two-round Delphi study of the views of consultant geriatricians in three Health Regions on the relative appropriateness of 12 possible performance measures for geriatric services. We compared geriatricians' responses with those of 44 cognitively-intact day hospital patients. Of 138 geriatricians, 89 responded to the first round postal survey, 84 to the second round. The rank order of geriatricians' suggestions did not change from round one to round two, and there was convergence of opinion with a significant decrease in the coefficients of variation of the ranks (p < 0.05, Wilcoxon Test). Geriatricians and patients gave high priority to 'reducing disability' and 'improving quality of life', and low priority to 'reducing mortality'. Geriatricians gave higher priority than patients to 'consumer satisfaction', 'problem resolution' and 'efficient use of resources'. Patients gave higher priority to 'reducing burden on carers', 'measures of service activity' and 'avoiding institutional care'. The study shows that it is possible to obtain a consensus amongst geriatricians about the priorities for measuring the performance of geriatric medical services. Similarities to and differences from patients' views illustrate the need to engage more than one group in the debate about appropriate measures of performance. Findings in both groups give support to recent attempts to develop and use assessment methods for the measurement of disability and quality of life in clinical practice.

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    • "Quality of life is regarded as a key healthcare outcome by patients and by clinicians; both groups see improvement in quality of life as an important function of Medicine for Older People services such as Day Hospitals [1]. Most Day Hospital services do not routinely measure quality of life however; the emphasis remains on the measurement of function [2,3], and it is thus difficult to know whether such services are successful in improving quality of life. "
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