Improving nursing home quality of care through outcomes data: the MDS quality indicators

Zimmerman, David

doi:10.1002/gps.820

Cited by 126 publications

(117 citation statements)

References 5 publications

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“…These indicators were compared with benchmark values derived from data on all residents of residential facilities in the Netherlands obtained using this instrument. 19,20 Further details of the model of multidisciplinary integrated care are found in Appendix 1 (available at www .cmaj .ca /lookup /suppl/doi:10.1503/cmaj.101498/-/DC1).…”

mentioning

confidence: 99%

Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial

Boorsma¹,

Frijters²,

Knol³

et al. 2011

Canadian Medical Association Journal

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mentioning

confidence: 99%

Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial

Boorsma¹,

Frijters²,

Knol³

et al. 2011

Canadian Medical Association Journal

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“…Our data suggest that Form CMS-2728 can serve as a potential indicator of overall quality of care in addition to its traditional role as a source of data used in outcomes studies. 24 In this way, Form CMS-2728 could provide a simple and important starting point for identifying potential dialysis facility quality issues. Like other administrative data gathered from the provision of health services, Form CMS-2728 was not created with the explicit purpose of evaluating quality of care.…”

Section: Discussionmentioning

confidence: 99%

Form CMS-2728 Data Versus Erythropoietin Claims Data: Implications for Quality of Care Studies

et al. 2012

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Medical Evidence Report Form CMS-2728 data is frequently used to study US dialysis patients, but the validity of these data have been called into question. We compared predialysis erythropoietin use as recorded on Form CMS-2728 with claims data as part of an assessment of quality of care among hemodialysis patients. Medicare claims were linked to Form CMS-2728 data for 18,870 patients. Dialysis patients, 67 years old or older, who started dialysis from 1 June 2005 to 31 May 2007 were eligible. Logistic and multivariate regressions were used to compare the use of either Form CMS-2728 or the corresponding claims data to predict mortality and the probability of meeting target hemoglobin levels. The sensitivity, specificity, and kappa coefficient for the predialysis erythropoietin indicator were 58.0%, 78.4%, and 0.36, respectively. Patients with a predialysis erythropoietin claim were less likely to die compared with patients without a claim (odds ratio ¼ 0.80 and 95% confidence interval ¼ 0.74-0.87), but there was no relationship observed between predialysis care and death using only Form CMS-2728 predictors. At the facility level, a predialysis erythropoietin claim was associated with a 0.085 increase in the rate of meeting target hemoglobin levels compared with patients without a claim (p ¼ 0.041), but no statistically significant relationship was observed when using the Form CMS-2728 indicators. The agreement between Form CMS-2728 and claims data is poor and discordant results are observed when comparing the use of these data sources to predict health outcomes. Facilities with higher agreement between the two data sources may provide greater quality of care.

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“…[46] The primary use of the RAI is clinical, to assess residents on admission to a nursing home, annually following placement, if status significantly changes and to develop individualized plans of care. [47] The first major component of the national resident assessment system for nursing home facilities was the Minimum Data Set (MDS) for nursing homes.…”

Section: Resident Assessment Instrumentmentioning

confidence: 99%

“…[ 48] The MDS for nursing home version 2.0 is used for the resident assessment process in nursing homes in the US, Canada, Holland, Japan and several other countries. [46,49] The MDS 2.0 provides a structure and language to understand longterm care and describes the nursing home population for planning and policy efforts. [48] Interrater reliability of items and internal consistency of MDS summary scales is usually good to excellent.…”

Section: Resident Assessment Instrumentmentioning

confidence: 99%

Planning the Restructuring of Long-Term Care: The Demand, Need and Provision of Institutional Long-Term Care Beds in Newfoundland and Labrador

Hughes

McDonald

Barrett

et al. 2008

Healthc Manage Forum

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The demand for long-term care (LTC) services in Canada is increasing because the population is aging. In Newfoundland and Labrador (NL) nursing homes (NHs) and supervised care (SC) facilities provide long-term care. There may be a mismatch between the provision of LTC beds and the needs of clients. To compare the type and annual rate of clients seeking placement to LTC, incident annual cohorts (N=l496) in five provincial health regions within Newfoundland and Labrador were compared using objective measures of disability, the Alberta Resident Classification Scores (ARCS) and the Resource Utilization Groups (RUGs lll). Client's need was assessed using a decision tree and optimal distribution of LTC beds determined. Regional incidence rates by disability of clients were compared, and whether these differences were associated with differences in the rate of supervised care (SC) or nursing home (NH) beds provided.. Within the four regions of Newfoundland little difference was observed in degree of disability, but Labrador clients differed from the island regions in age, degree and type of disability. Annual rate of presentation for LTC differed by region, with the highest incidence rate of LTC clients in regions with highest rates of supervised care (SC) beds and lowest rates of nursing home (NH) beds.Thirty four% of applicants for LTC were referred for supervised care placement and sixty six %for nursing home. However, seven % had no functional disability being independent for activities of daily living, were continent and without cognitive impairment (CI). Fifteen % of clients recommended for nursing home had no indicators for nursing home. A decision tree suggested that optimal placement was seven % to 11 supportive hou ing, thirty four% to supervi ed care, 17% to upervi ed care for cognitive impairment, and 42% to nursing home.In NL, a large component of institutional LTC is nursing home , whereas the major need is for appropriate supervised care for those with mode t di ability, with or without cognitive impairment. Different approaches to restructuring of long term care in each region are necessary because of differences in rates of presentation for LTC and availability of nursing home and appropriate supervised care beds.111

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Improving nursing home quality of care through outcomes data: the MDS quality indicators

Abstract: The indicators have several possible applications: a source of consumer information; to help guide policy makers; and to assist providers in conducting quality improvement initiatives and to evaluate the impact of these efforts.

Cited by 126 publications

References 5 publications

Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial

Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial

Form CMS-2728 Data Versus Erythropoietin Claims Data: Implications for Quality of Care Studies

Planning the Restructuring of Long-Term Care: The Demand, Need and Provision of Institutional Long-Term Care Beds in Newfoundland and Labrador

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