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Development of a risk-adjusted urinary incontinence outcome measure of quality for nursing homes.
Med Care. 2003 Apr; 41(4):467-78.MC

Abstract

BACKGROUND

Quality of nursing home care is of ongoing concern. The availability of uniform, patient-level information-the Minimum Data Set (MDS)-offers the opportunity to assess quality based on risk-adjusted health outcomes.

OBJECTIVE

To develop a risk-adjusted measure of quality based on urinary incontinence (UI) outcomes for nursing homes, derived from the MDS.

RESEARCH DESIGN

A retrospective statistical analysis of individual resident level data.

SUBJECTS

MDS+ data for 46,453 residents of 671 nursing homes in New York State during the 1995 to 1997 period.

MEASURES

Improvement in UI status was defined based on the resident's UI status at 3 months post admission relative to status at admission. Individual risk factors were also defined at admission. Facility level quality indicators were developed.

RESULTS

Facility level indicators show substantial variation. An average facility, providing average quality care to a population of average risk, would experience improvement in UI outcomes for 11 of its 25 admissions in a year. The difference between the best and the worst facilities (two standard deviations above and below the average) is eight new residents with improvement in UI outcomes out of 25 annual admissions.

CONCLUSIONS

This study demonstrates the feasibility of measuring quality of UI care based on nationally available MDS data. The measures presented can be used to support internal quality improvement efforts. Before such measures can be used externally, either in the survey process or in quality report cards, they should be further validated.

Authors+Show Affiliations

Department of Community and Preventive Medicine, University of Rochester Medical Center, New York 14642, USA. Dana_Mukamel@urmc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12665711

Citation

Mukamel, Dana B., et al. "Development of a Risk-adjusted Urinary Incontinence Outcome Measure of Quality for Nursing Homes." Medical Care, vol. 41, no. 4, 2003, pp. 467-78.
Mukamel DB, Watson NM, Meng H, et al. Development of a risk-adjusted urinary incontinence outcome measure of quality for nursing homes. Med Care. 2003;41(4):467-78.
Mukamel, D. B., Watson, N. M., Meng, H., & Spector, W. D. (2003). Development of a risk-adjusted urinary incontinence outcome measure of quality for nursing homes. Medical Care, 41(4), 467-78.
Mukamel DB, et al. Development of a Risk-adjusted Urinary Incontinence Outcome Measure of Quality for Nursing Homes. Med Care. 2003;41(4):467-78. PubMed PMID: 12665711.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Development of a risk-adjusted urinary incontinence outcome measure of quality for nursing homes. AU - Mukamel,Dana B, AU - Watson,Nancy M, AU - Meng,Hongdao, AU - Spector,William D, PY - 2003/4/1/pubmed PY - 2003/4/19/medline PY - 2003/4/1/entrez SP - 467 EP - 78 JF - Medical care JO - Med Care VL - 41 IS - 4 N2 - BACKGROUND: Quality of nursing home care is of ongoing concern. The availability of uniform, patient-level information-the Minimum Data Set (MDS)-offers the opportunity to assess quality based on risk-adjusted health outcomes. OBJECTIVE: To develop a risk-adjusted measure of quality based on urinary incontinence (UI) outcomes for nursing homes, derived from the MDS. RESEARCH DESIGN: A retrospective statistical analysis of individual resident level data. SUBJECTS: MDS+ data for 46,453 residents of 671 nursing homes in New York State during the 1995 to 1997 period. MEASURES: Improvement in UI status was defined based on the resident's UI status at 3 months post admission relative to status at admission. Individual risk factors were also defined at admission. Facility level quality indicators were developed. RESULTS: Facility level indicators show substantial variation. An average facility, providing average quality care to a population of average risk, would experience improvement in UI outcomes for 11 of its 25 admissions in a year. The difference between the best and the worst facilities (two standard deviations above and below the average) is eight new residents with improvement in UI outcomes out of 25 annual admissions. CONCLUSIONS: This study demonstrates the feasibility of measuring quality of UI care based on nationally available MDS data. The measures presented can be used to support internal quality improvement efforts. Before such measures can be used externally, either in the survey process or in quality report cards, they should be further validated. SN - 0025-7079 UR - https://www.unboundmedicine.com/medline/citation/12665711/Development_of_a_risk_adjusted_urinary_incontinence_outcome_measure_of_quality_for_nursing_homes_ L2 - https://doi.org/10.1097/01.MLR.0000053227.95476.02 DB - PRIME DP - Unbound Medicine ER -