It is feasible to integrate the programmatic, data collection, data transmission, and outcome enhancement components of OBQI into the day-to-day operations of home health agencies. The aggregate findings and the agency-level evidence available from site-specific communications suggest that OBQI had a pervasive effect on outcome improvement for home health patients. OBQI appears to warrant expansion and refinement in HHC and experimentation in other healthcare settings.

Today many feminists seem relatively content with the treatment of rape and other sexual violence against women under international criminal law. In the context of the conflict in Bosnia and Herzegovina in the early 1990s, feminist activists made a concerted effort to affect the statute establishing the International Criminal Tribunal for the Former Yugoslavia (ICTY), the rules of evidence under which rape and other crimes of sexual violence would be prosecuted, the form the indictments of crimes of sexual violence would take, and the strategies and legal argumentation made at both the trial and the appellate levels. For the most part, much to the surprise of many feminists themselves, they have been successful. As Joanne Barkan comments: “From the start, most observers considered the [ICTY] a sop to human rights and feminist activists who wanted intervention.... Almost no one expected it to succeed. And yet to some extent, at least for women, it did.”

The Outcome and Assessment Information Set (OASIS) is used for outcome reporting, quality improvement, and case mix adjustment of per-episode payment for home health care. The research described here addresses interrater reliability of OASIS items and compares clinician time required to complete patient assessment with and without OASIS. Interrater reliability for OASIS data items was estimated using independent assessments by two clinicians for a sample of 66 patients. Incremental assessment time due to OASIS was estimated using interview data from two agency-matched groups of clinical care providers--one group who used OASIS in the assessment and a second group whose assessment did not include OASIS items. Interrater reliability is excellent (kappa > .80) for many OASIS items and substantial (kappa > 0.60) for most items. The reported time required to complete an assessment with OASIS did not differ from the time required for a comparable assessment without OASIS. The results of this study are being used to guide developmental efforts to improve OASIS items. They can also be informative to home health care agencies when interpreting OASIS-based outcome and case mix reports.

No abstract

No abstract