Managed Care Weekly Digest

New medicare and medicaid study findings have been reported from University of Wisconsin

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"Congress has mandated that the Centers for Medicare & Medicaid Services develop a uniform assessment instrument that characterizes patients' needs for postacute services. What scientific criteria should be used to evaluate the evidence for such a tool? The validity of a measure can be accurately graded only if the constructs measured and their applications are clearly defined. We argue that improving postacute placement is the main purpose of the uniform postacute assessment (recently renamed the Continuity Assessment Record and Evaluation). We argue that placement itself needs to be better defined and measured in terms of transitions in the level and type of treatment and care. Domains that should be measured to provide appropriate rehabilitative placement recommendations include level of skilled medical and nursing care, therapies, routine living support, family support, ability to participate in self-care, and patient preference. Almost no research has been performed to quantify and predict the needed intensity of rehabilitative therapy, a major lacuna in evidence. Criteria and examples are provided for research that will provide minimal, probably adequate, or strong evidence for the validity of systems that recommend care transitions," wrote M.V. Johnston and colleagues, University of Wisconsin.

The researchers concluded: "A longterm program of research and systematic evidence synthesis is needed to support guidelines that improve postacute placement."

Johnston and colleagues published their study in Archives of Physical Medicine and Rehabilitation (The uniform postacute assessment tool: Systematically evaluating the quality of measurement evidence. Archives of Physical Medicine and Rehabilitation, 2007;88(11):1505-1512).

For additional information, contact M.V. Johnston, University of Wisconsin, Dept. of Occupational Therapy, College Health Science & Nursing, POB 413, Milwaukee, WI 53201, USA.

Publisher contact information for the journal Archives of Physical Medicine and Rehabilitation is: W B Saunders Co-Elsevier Inc., 1600 John F Kennedy Boulevard, Ste. 1800, Philadelphia, PA 19103-2899, USA.

Keywords: United States, Milwaukee, Medicare and Medicaid, Health Policy, Medicaid, Medicare, Rehabilitation Research, Therapy, Treatment, University of Wisconsin.

This article was prepared by Managed Care Weekly Digest editors from staff and other reports. Copyright 2008, Managed Care Weekly Digest via NewsRx.com.