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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Howard B Degenholtz, PhD, Department of Health Policy and Management, GSPH, University of Pittsburgh, 3708 5th Ave. Suite 300, Pittsburgh, PA 15206, (412) 647-5860, degen@pitt.edu, Robert L. Kane, MD, Health Services Research and Policy, University of Minnesota School of Public Health, D351 Mayo (MMC 197), 420 Delaware Street SE, Minneapolis, MN 55455, W-C Lin, PhD, Departm,ent of family and Community Medicine, University of Missouri-Columbia, M228 Medical Sciences Bldg, Columbia, MO 65212, and Y-S Lum, PhD, School of Social Work, University of Minnesota, 105 Peters Hall, 1404 Gortner Ave, St. Paul, MN 55108.
Data on nursing home residents is now universally available through the mandatory Minimum Data Set (MDS). This data is being widely used for research on nursing home care. This presentation will address several elements important in using the MDS correctly: 1] the limitations of its accuracy, 2] issues around subject identification and linkage, 3] creating quality indicators, 4] applying appropriate risk adjustment, and 5] issues of data linkage. We will illustrate these issues with the experience gained from three large studies: 1] an evaluation of persons dually eligible for Medicaid and Medicare services (MSHO), 2] an evaluation of the EverCare program (EC), a Medicare capitated program specifically for nursing home residents, and 3] a project to develop measures of nursing home quality of life (QoL). The MSHO and EC projects included a survey of nursing home residents. When the survey results for pain and function were compared to proximate MDS reports for the same residents there were substantial discrepancies. Nonetheless, the MDS data was used to assess quality in the MSHO and EC studies. Both cross-sectional and longitudinal measures were developed. For the former a new approach to case mix adjustment was applied to the 24 quality indicators (QIs) developed from the MDS data by CHSRA. In the analyses the MDS data had to be matched to the residents in the study samples. Some analyses used facility level data and others were restricted to the study sample. The QoL study examined the relationships between facility scores for QoL and various QI scores.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to
Keywords: Aging, Medicare
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Contractor with CMS