Purpose: International studies of health and health care allow identification and examination of important population and health system characteristics. The development of standardized health data and nomenclatures (e.g. ICD), and standardized measurement of health status/outcomes, are essential for supporting global cooperative health ventures and cross-national research efforts. This presentation reports on preliminary development of a standardized universal instrument designed to measure health care outcomes on varied populations across a number of international settings.
Design/Method: The Palmer College Clinic Abroad Program (CAP) is an outreach service providing chiropractic health care through short-term clinic sites in developing and other nations. A health care outcomes instrument was needed in order to measure patient-reported improvement following chiropractic care. Given the dual barriers of language and literacy at the CAP sites, an original instrument was created by modifying pediatrics instruments (graphics on a numeric rating scale), to minimize reliance on written English and maximize universal applicability. The validity, reliability, and usefulness of the health outcomes data collection instrument is continually evaluated for improvements.
Results/Discussion: Compliance with “review of systems” ranged from 98% to 51%, by site. Compliance with completing various elements of the outcomes instrument ranged from 54% to 3%, depending on site and specific element. Factors which may affect compliance include population characteristics (language, literacy, sociocultural); provider characteristics (language, trainees’ clinical skills level, mentor/trainee ratio, mentor’s evaluative proficiency); and characteristics of the setting/instrument (use of local interpreters, patient/clinician ratio, whether translated written instrument was used, specific relevance of instrument data elements to the encounter).
Learning Objectives: 1. Recognize the importance of standardized global outcomes instruments 2. Appreciate the complexity of creating standardized instruments for use with global populations 3. Discuss approaches for evaluating and improving measurement instruments
Keywords: Chiropractic, Outcome Measures
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.