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PACE evaluation methods Noreen Clark Center for Managing Chronic Disease
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PACE
hysiciansthmaareducation
Evaluation Methods
Patient Outcomes
Health SystemFactors
(non-MD)
OtherConfounders
Parental Factors
Patient Factors
EnvironmentFactors
Physician Factors
Provider Attitudes
Provider Behavior
Provider Knowledge
PACE
hysiciansthmaareducation
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
Provider Attitudes
Provider Behavior
Provider Knowledge
PACE
hysiciansthmaareducation
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
Patient Outcomes
Health SystemFactors
(non-MD)
OtherConfounders
Parental Factors
Patient Factors
EnvironmentFactors
Physician Factors
Provider Attitudes
Provider Behavior
Provider Knowledge
PACE
hysiciansthmaareducation
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)
Patient Outcomes
Health SystemFactors
(non-MD)
OtherConfounders
Parental Factors
Patient Factors
EnvironmentFactors
Physician Factors
Provider Attitudes
Provider Behavior
Provider Knowledge
PACE
hysiciansthmaareducation
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”
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
