Abstract
BackgroundIntegrated delivery methods in healthcare systems have been proposed to confront the increasing complexity in general health care. INTERMED is an empirically derived, observer-rated instrument to measure case complexity. It was intended as a visualized, action-oriented decision-support tool for the early assessment of bio-psychosocial health risks and health needs. This study aims to document the reliability and applicability of the Spanish version of INTERMED in liver transplant patients.MethodsCross-sectional study of patients who had been included in the liver transplant waiting list. Two nurses interviewed the patients with INTERMED, and scored the instrument blind to each other. Kappa and w-kappa, Spearman, Kendall and intraclass correlation coefficients, and Cronbach's alfa were calculated.ResultsNo patient refused the interview. Satisfactory coefficients were documented in most INTERMED items. Kappa was = 0.858 for the categorization of patients as "complex", and 21 of them (48.8%) were classified in this category, and were considered to need integrated treatment.ConclusionsThe Spanish version of INTERMED is reliable. Its applicability in liver transplant patients adds to its generalizability.
Highlights
Integrated delivery methods in healthcare systems have been proposed to confront the increasing complexity in general health care
The validity of this instrument has been documented in patients admitted to internal medicine [9], and in specific diagnostic groups including patients in dialysis [17], with low back pain [18], terminal cancer [19], diabetes [2], rheumatoid arthritis [20], multiple sclerosis [11] and pulmonary patients [21]
It has been shown that compared with usual care, nurse-led interventions based on INTERMED scores resulted in improvements in quality of life at discharge in a sample of general medical patients [22]
Summary
Integrated delivery methods in healthcare systems have been proposed to confront the increasing complexity in general health care. The reliability of INTERMED, which may be applied by nurses, was reported in a trauma center [7] and in a heterogeneous sample of patients with somatic conditions [16] The validity of this instrument has been documented in patients admitted to internal medicine [9], and in specific diagnostic groups including patients in dialysis [17], with low back pain [18], terminal cancer [19], diabetes [2], rheumatoid arthritis [20], multiple sclerosis [11] and pulmonary patients [21]. It has been shown that compared with usual care, nurse-led interventions based on INTERMED scores resulted in improvements in quality of life at discharge in a sample of general medical patients [22]
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