National release of the nursing home quality report cards: implications of statistical methodology for risk adjustment.

ABSTRACT:

Objective

To determine how alternative statistical risk-adjustment methods may affect the quality measures (QMs) in nursing home (NH) report cards.

Data sources/study settings

Secondary data from the national Minimum Data Set files of 2004 and 2005 that include 605,433 long-term residents in 9,336 facilities.

Study design

We estimated risk-adjusted QMs of decline in activities of daily living (ADL) functioning using classical, fixed-effects, and random-effects logistic models. Risk-adjusted QMs were compared with each other, and with the published QM (unadjusted) in identifying high- and low-quality facilities by either the rankings or 95 percent confidence intervals of QMs.

Principal findings

Risk-adjusted QMs showed better overall agreement (or convergent val

SUBMITTER: Li Y 

PROVIDER: S-EPMC2669625 | biostudies-literature | 2009 Feb

REPOSITORIES: biostudies-literature