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P A C E hysician sthma are ducation Evaluation Methods

PACE evaluation methods

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PACE evaluation methods Noreen Clark Center for Managing Chronic Disease

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Page 1: PACE evaluation methods

PACE

hysiciansthmaareducation

Evaluation Methods

Page 2: PACE evaluation methods

Patient Outcomes

Health SystemFactors

(non-MD)

OtherConfounders

Parental Factors

Patient Factors

EnvironmentFactors

Physician Factors

Provider Attitudes

Provider Behavior

Provider Knowledge

PACE

hysiciansthmaareducation

Page 3: PACE evaluation methods

Provider Survey

• Measure changes in knowledge, attitudes and self-reported provider behavior

• Self-administered

• Immediately before and after the seminar

• Pros & Cons:– Relatively inexpensive– Difficult to maintain high response rate– No patient outcomes– Self-reported behavior

Page 4: PACE evaluation methods

Provider Attitudes

Provider Behavior

Provider Knowledge

PACE

hysiciansthmaareducation

Page 5: PACE evaluation methods

Medical Record Audit

• Measure changes in provider behavior• Requires trained chart reviewers • Pros & Cons:

– Information regarding physician prescription, outpatient visits (urgent & non-urgent)

– Poor documentation of asthma counseling, asthma severity

– Consent may be required from each patient/parent– Information on outpatient asthma health care utilization

Page 6: PACE evaluation methods

Patient Outcomes

Health SystemFactors

(non-MD)

OtherConfounders

Parental Factors

Patient Factors

EnvironmentFactors

Physician Factors

Provider Attitudes

Provider Behavior

Provider Knowledge

PACE

hysiciansthmaareducation

Page 7: PACE evaluation methods

Parent Telephone Survey• Measure changes in outcomes, self-management

• Requires trained telephone interviewers

• Pros & Cons:– Information on outpatient asthma health care utilization, parent

perceptions of physician behavior, asthma severity and asthma control

– Difficult to schedule, high cost– Consent required from each patient/parent– May need to confirm medications, actual physician prescription

(versus patient adherence)

Page 8: PACE evaluation methods

Patient Outcomes

Health SystemFactors

(non-MD)

OtherConfounders

Parental Factors

Patient Factors

EnvironmentFactors

Physician Factors

Provider Attitudes

Provider Behavior

Provider Knowledge

PACE

hysiciansthmaareducation

Page 9: PACE evaluation methods

Claims Data• Measure changes asthma health care utilization• Requires trained analyst/programmer• Pros & Cons:

– Information on outpatient asthma health care utilization– No clinical information (appropriateness of controller medications

for persistent asthma; determining if ED visit or hospitalization is due to asthma)

– Difficult to attribute claim to a specific physician– Multiple patients belong to different MCOs– No consistent CPT codes for “asthma counseling”

Page 10: PACE evaluation methods

Annual Data CollectionOutcome of Interest Source

Physician Knowledge Mailed Surveys

Physician Attitudes Mailed Surveys

Physician Behavior Chart AuditsPatient Surveys

Patient Outcomes Chart AuditsPatient Surveys

PACE

hysiciansthmaareducation