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Tijdschrift voor Gerontologie en Geriatrie

, Volume 48, Issue 6, pp 287–296 | Cite as

Eerste ervaringen met patiënt gerapporteerde uitkomstmaten in de geriatrie

  • Marleen Hems
  • Marleen Harkes
  • Margriet Moret-Hartman
  • René J. F. Melis
  • Yvonne Schoon
Article

Samenvatting

Achtergrond

De kwaliteit van zorg in de klinische geriatrie is gericht op kwaliteit van leven en behoud van functionaliteit en derhalve moeilijk uit te drukken met uitkomstindicatoren als genezingskans of mortaliteit. Daarom zijn patiënt gerapporteerde uitkomstmaten (patient reported outcome measures, PROMs) in de geriatrie mogelijk betere indicatoren voor gezondheid. In 2015 gaf de NVKG de Commissie Kwaliteitsmeting de opdracht om een geschikte PROM te selecteren voor geriatrische ziekenhuispatiënten.

Methode/resultaten

De werkgroep stelde vast dat het doel van de PROM is het meten van uitkomsten vanuit het perspectief van de oudere patiënt waarbij de klinisch geriater betrokken is bij de zorg. Vanuit de literatuur werden vier mogelijke PROMs geïdentificeerd, waarna middels vooraf gestelde selectiecriteria TOPICS-MDS als meest geschikte werd bevonden. Voor haalbaar gebruik in de zorg, is TOPICS-MDS middels een itemreductie-studie ingekort. Dit resulteerde in TOPICS-Short Form (SF). Achtereenvolgens werden twee pilots gedaan op drie ziekenhuisafdelingen geriatrie. De eerste pilot met TOPICS-MDS had een respons van 62 % en de tweede een respons van 37 %. Gedurende en na de opname verbeterde onder andere de functionaliteit (Katz-15).

Conclusie

De TOPICS-SF werd gekozen als PROM en is uitvoerbaar in de praktijk. Een vervolgtraject met een grotere steekproef is nodig om aan te tonen dat deze PROM herstel en gezondheids- en welzijnswinst bij ouderen kan meten.

Trefwoorden

patient reported outcome measures (PROM) zorgkwaliteit uitkomstindicatoren ziekenhuiszorg ouderen TOPICS-SF 

Patient reported outcome measures in geriatric care: first experiences

Abstract

Background

There are difficulties in expressing the value of geriatric care in outcome measures such as recovery or mortality rates. Rather, the goal of geriatric care is to maintain quality of life and functionality. As such, patient reported outcome measures (PROMs) may be more effective in measuring the value healthcare creates in geriatric patients. In 2015 the Dutch Geriatrics Society asked their Committee Quality of Care Measurement to select a suitable PROM for the purpose of measuring the outcomes of geriatric hospital care.

Methods/results

The goal of this PROM is to measure outcomes of an hospital admission in the perspective of the elderly patient who was admitted to a geriatric ward. A group of caregivers in geriatric care identified four possible PROMs in the literature and based on selection criteria the TOPICS-MDS was chosen as most suitable. To increase the feasibility of implementation in daily practice, an item reduction study was performed and this resulted in a short form: TOPICS-SF. Two pilot studies in three hospitals took place on a geriatric ward. A response of 62% was observed during the first pilot with TOPICS-MDS and a response of 37% was observed during the second pilot with TOPICS-SF. The Katz-15 improved during hospital stay and during one month at home after discharge.

Conclusion

The TOPICS-SF has been selected as PROM for the older patient receiving geriatric care and is feasible in practice. More research in different settings and with different moments of measurements is needed to evaluate the responsiveness of TOPICS-SF and the conditions for feasible implementation in daily practice.

Keywords

Patient reported outcome measures (PROM) Quality of healthcare Outcome measures Hospital care elderly TOPICS-SF 

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Copyright information

© Vilans 2017

Authors and Affiliations

  • Marleen Hems
    • 1
  • Marleen Harkes
    • 2
  • Margriet Moret-Hartman
    • 3
  • René J. F. Melis
    • 4
  • Yvonne Schoon
    • 4
  1. 1.Catharina Ziekenhuis EindhovenEindhovenNederland
  2. 2.GeriatrieHavenziekenhuis RotterdamRotterdamNederland
  3. 3.Kennisinstituut van Medisch SpecialistenUtrechtNederland
  4. 4.Radboudumc NijmegenNijmegenNederland

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