Creating Value with Measurement: Moving toward the Patient

Abstract

The rehabilitation marketplace has evolved from a provider- to a payer-driven environment. Eventually, rehabilitation will be consumer directed, necessitating client-centered measures. Outcome measurement for stroke is thus discussed in terms of moving measurement toward the patient. “Handicap and quality of life” are incorporated into a model in which client-centered domains are addressed to meet four objectives: satisfy consumer need, serve as a resource for clinical management, meet regulatory/payer requirements and, in effect, provide value to those who measure. Case-mix adjustment is discussed as the next refinement in benchmarking quality. The influence of payment incentive, setting, and accreditation are reviewed.

Keywords:

• outcome
• handicap
• stroke
• case-mix adjustment
• measurement