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Outcome Based Center Comparisons in Inpatient Cardiac Rehabilitation Results from the EVA-Reha (R) Cardiology Project

  • Background: So far, for center comparisons in inpatient cardiac rehabilitation (CR), the objective outcome quality was neglected because of challenges in quantifying the overall success of CR. In this article, a multifactorial benchmark model measuring the individual rehabilitation success is presented. Methods: In 21 rehabilitation centers, 5 123 patients were consecutively enrolled between 01/2010 and 12/2012 in the prospective multicenter registry EVA-Reha (R) Cardiology. Changes in 13 indicators in the areas cardiovascular risk factors, physical performance and subjective health during rehabilitation were evaluated according to levels of severity. Changes were only rated for patients who needed a medical intervention. Additionally, the changes had to be clinically relevant. Therefore Minimal Important Differences (MID) were predefined. Ratings were combined to a single score, the multiple outcome criterion (MEK). Results: The MEK was determined for all patients (71.7 +/- 7.4 years, 76.9 % men) and consisted of an average of 5.6Background: So far, for center comparisons in inpatient cardiac rehabilitation (CR), the objective outcome quality was neglected because of challenges in quantifying the overall success of CR. In this article, a multifactorial benchmark model measuring the individual rehabilitation success is presented. Methods: In 21 rehabilitation centers, 5 123 patients were consecutively enrolled between 01/2010 and 12/2012 in the prospective multicenter registry EVA-Reha (R) Cardiology. Changes in 13 indicators in the areas cardiovascular risk factors, physical performance and subjective health during rehabilitation were evaluated according to levels of severity. Changes were only rated for patients who needed a medical intervention. Additionally, the changes had to be clinically relevant. Therefore Minimal Important Differences (MID) were predefined. Ratings were combined to a single score, the multiple outcome criterion (MEK). Results: The MEK was determined for all patients (71.7 +/- 7.4 years, 76.9 % men) and consisted of an average of 5.6 indicators. After risk adjustment for sociodemographic and clinical baseline parameters, MEK was used for center ranking. In addition, individual results of indicators were compared with means of all study sites. Conclusion: With the method presented here, the outcome quality can be quantified and outcome-based comparisons of providers can be made.show moreshow less

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Metadaten
Author:Bernd Röhrig, Annett SalzwedelORCiDGND, Sigrid Linck-Eleftheriadis, Heinz VöllerORCiDGND, Manfred Nosper
DOI:https://doi.org/10.1055/s-0034-1395556
ISSN:0034-3536 (print)
ISSN:1439-1309 (online)
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=25675321
Parent Title (German):Die Rehabilitation : Zeitschrift für Praxis und Forschung in der Rehabilitation
Publisher:Thieme
Place of publication:Stuttgart
Document Type:Article
Language:German
Year of first Publication:2015
Year of Completion:2015
Release Date:2017/03/27
Tag:benchmark; cardiac rehabilitation; outcome quality; profiling; quality assurance
Volume:54
Issue:1
Pagenumber:8
First Page:45
Last Page:52
Organizational units:Humanwissenschaftliche Fakultät / Institut für Sportwissenschaft
Peer Review:Referiert