Assessing Cirrhosis Quality of Care While Accounting for Cost

Study Overview
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Brief Summary
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The objective of this study is to determine what influences the patient and caregiver perception of care, and if this perception associates with the percentage of and what quality metrics are being met and outcomes. The investigators also plan to capture the cost of providing quality metrics and the cost of monitoring adherence to quality metrics.

Detailed Description
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This study will be conducted using mixed-methods. The qualitative part will consist of in person, 1:1, open ended in depth interviews using a standard interview guide with probes. The quantitative part will document subjects meeting or not meeting the quality metrics supported by strong evidence, clinical outcomes, and medical bills.

Official Title
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Assessing Cirrhosis Quality of Care While Accounting for Cost: Is the Patient and/or Caregiver Perspective Associated With Outcomes or Quality Metrics, and What is the Cost of Implementing and Measuring Quality Metrics

Conditions
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Liver Cirrhosis

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: primary liver cirrhosis receiving care at the study cite no evidence of hepatic encephalopathy if the subject is providing consent Exclusion Criteria: no documentation of cirrhosis unable to confirm diagnosis of cirrhosis by imaging or pathology

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental<br>Qualitative interview | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Participant perceptions of care | Qualitative interview performed where the participant describes their experience of the quality of care they have received. | 2 years | 
| Relationship of perceptions of quality of care to recent hospitalizations | Assess associations of qualitative themes that emerge from the qualitative interview with hospitalization frequency | 2 years | 
| Relationship of perceptions of quality of care to portal hypertension quality metric adherence | Assess associations of qualitative themes that emerge from the qualitative interview with physician meeting of portal hypertension quality metric (i.e., physician follows the recommended management (yes/no)). | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assess if portal hypertension quality metric adherence equates to less hospitalizations | To see if there is an association of portal hypertension quality metric adherence (i.e. physician follows the recommended management of portal hypertension (yes/no)) to frequency of hospitalizations. | 2 years | 
| Association of quality metric adherence with survival | We will explore adherence with proposed portal hypertension quality metric (physician follows the management (yes/no)) to see if there is an association with survival. The quality metric will be identified as either being met or not met, and survival will also be identified as having occurred or not. | 2 years |