In Arkansas, almost all of the high-risk-pregnancy resources are concentrated in a single place, at the University of Arkansas for Medical Sciences (UAMS). During the 6-month period before a telemedicine programme started, there were five operational telemedicine sites in the state, and during the subsequent 12-month period, there were 13 telemedicine sites in operation. Data were gathered on birth-related transfers during the two periods. Qualitative comparative analysis (QCA) was used to assess the effect of different combinations of telemedical and hospital-level resources on the timing of maternal transfers. Early (pre-33-week gestational age) maternal transfers occurred in period 1 (before the telemedicine programme started), only from areas with level-2 hospital resources and no telemedicine access; early transfers also occurred in period 2 from areas with level-2 hospital resources and either telemedicine access or no telemedicine access. We conclude that combinations of resources affect physician decisions regarding transfer and that QCA is a useful tool for examining the growth and development of telemedicine systems.
[Show abstract][Hide abstract] ABSTRACT: Determine, using fuzzy set qualitative comparative analysis (fs/QCA), the relationship between patient-centered medical home (PCMH) systems and quality in 21 NCQA recognized medical homes.
Primary data collected in 2009, including measures of optimal diabetes care (ODC), preventive services up-to-date (PSUTD), patient experience (PEX), survey data assessing PCMH capabilities (PPC-RS), and other clinic characteristics.
Cross-sectional study identifying associations between PPC-RS domains, demographic, socioeconomic, and co-morbidity measures, and quality outcomes.
PPC-RS scores were obtained by surveying clinic leaders. PSUTD and ODC scores were obtained from provider performance data. PEX data were obtained from patient surveys. Demographic, socioeconomic, and co-morbidity data were obtained from EMR and census data.
fs/QCA identified associations between all three outcomes and PCMH capabilities: ODC and team-based care; PSUTD and preventive services systems; and all three outcomes and provider performance reporting systems. Previous statistical analysis of this data had failed to identify these relationships.
fs/QCA identified important associations that were overlooked using conventional statistics in a small-N health services data set. PCMH capabilities are associated with quality outcomes.
Health Services Research 08/2011; 47(1 Pt 1):22-45. DOI:10.1111/j.1475-6773.2011.01303.x · 2.78 Impact Factor
Note: This list is based on the publications in our database and might not be exhaustive.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.