coordination literature for people with disabilities is relatively new and
focuses on initial implementation of interventions rather than assessing the
quality of the implementation, says a new review
commissioned by the Agency for Healthcare Research and Quality (AHRQ). The
review is part of a series that provides a critical analysis of existing
literature on quality improvement strategies and issues for topics identified
by the 2003 Institute of Medicine report Priority Areas for National Action:
Transforming Health Care Quality. As part of its charge to continuously assess
progress toward quality and to update the list of priority areas, AHRQ
identified people with disabilities as a priority population.
For this review, the authors included all forms of disability except severe
and persistent mental illness for all age groups in outpatient and community
settings. They focused on outcomes, patient experience, and care coordination
process measures. They searched for generic outcome measures rather than
disability/condition-specific measures. They also looked for examples of
outcomes used in the context of disability as a complicating condition for a
set of basic service needs relevant to the general population, and secondary
conditions common to disability populations.
Of 15,513 articles screened, 15 articles were included for general outcome
measures and 44 studies for care coordination.
Overall, the reviewfound very few direct examples of work conducted from the
perspective of disability as a complicating condition. "Capturing the
disability perspective will require collaboration and coordination of
measurement efforts across medical interventions, rehabilitation, and social
support provision," the authors write.