Observational studyJournal of the American Geriatrics Society2014
Abbreviated care-process quality indicator sets linked with survival and functional status benefit in older adults under ambulatory care.
Observational study in Journal of the American Geriatrics Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Improving Quality and Value of Cancer Care for Older Adults.American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting · 2017Article
- Older Adults Reporting More Diabetes Mellitus Care Have Greater 9-Year Survival.Journal of the American Geriatrics Society · 2015Article
- Quality of Care Delivered Before vs After a Quality-Improvement Intervention for Acute Geriatric Trauma.Journal of the American College of Surgeons · 2015Observational
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectivesTo identify subsets of ambulatory care (outpatient only) quality indicators (QIs) associated with better survival and physical function outcomes.
designObservational cohort study.
settingPooled data from the Assessing Care of Vulnerable Elders (ACOVE)-1 study, which measured quality of care using 140 care-process QIs, and the subsequent ACOVE-2 study, which reduced the QIs to 69 ambulatory care QIs.
participantsOlder adults receiving ambulatory care (N=1,015). MEASUREMENTS: To prioritize and reduce the QIs into subsets, an expert panel rated each of 69 ambulatory care QIs for the strength of the link between process and benefit, defined as direct trial evidence on older adults or high expectation of benefit if a trial were conducted in older adults. This resulted in three reduced QI sets, reflecting their intended benefit: 17 QIs for survival (ACOVE Quality for Survival (AQS)-17), five QIs to preserve function (AQF-5), and 16 QIs to improve quality-of-life related to physical health and symptoms (AQQ-16). Whether AQS-17 would predict 3-year survival was first tested in 1,015 pooled ACOVE-1 and ACOVE-2 participants. Second, whether AQF-5 (n=74) and AQQ-16 (n=359) would predict change in the Physical Component Summary (PCS) score of the Medical Outcomes Study 12-item Short-Form Survey at 1 year was tested in the ACOVE-2 cohort. Control variables were age, function-based vulnerability, and comorbidity.
resultsEach 20-percentage-point increment in AQS-17 was associated with survival (hazard ratio (HR)=0.83, P=.01) up to 500 days but not thereafter. AQF-5, but not AQQ-16, predicted 1-year improvement in PCS score (1.13-points per 20%-point increment in AQF-5, P=.02).
conclusionSubsets of care processes can be linked with outcomes important to older adults. The AQS-17 and AQF-5 are potential tools for improving ambulatory care of older adults.
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