246475 Assessing reliability and validity of the outcome and assessment information set: Implications for health policy, practice and research

Monday, October 31, 2011: 1:06 PM

Joan K. Davitt, PhD, MSS, MLSP , School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA
Melissa O'Connor, MBA, BSN, RN, COS-C , School of Nursing, University of Pennsylvania, Philadelphia, PA
The Outcome and Assessment Information Set (OASIS), the Medicare-mandated home health assessment, is used to establish agency reimbursements, evaluate home health quality and for research. Thus, it is critical to ensure the validity and reliability of the items within the OASIS tool. A comprehensive, systematic review of the empirical literature testing either validity or reliability of the OASIS was conducted, yielding twelve studies between 1999 and 2010. Data were extracted in a three-step process using a structured narrative template that reviewed the type of validity/reliability tested, methods/design, sampling procedures, measures, significant findings and limitations of each study. Methodologies employed in the reviewed studies included secondary analysis, video simulation, retrospective and prospective cohort designs, some with random but most with convenience samples. Seven studies analyzed validity; both construct and criterion-related validity were studied as well as unidimensionality of certain domains. Validity was evaluated by comparing various OASIS measures to existing “gold-standard” scales, expert-derived correct answers, or hospital admission rates. Some studies used home care staff, while others used research personnel to complete assessments. Nine studies evaluated reliability, including intra-rater, inter-rater, and internal consistency reliability. Empirical findings indicate the validity and reliability of the OASIS varies depending upon the item studied. Differing methodologies and statistical measures make comparison between studies difficult. Further research is needed to investigate the psychometric properties of the OASIS to confirm its value in measuring patient outcomes for research, quality improvement and policy. Researchers must use caution in studying home health outcomes via the OASIS data.

Learning Areas:
Provision of health care to the public
Public health administration or related administration
Public health or related public policy

Learning Objectives:
1)Evaluate the existing literature on the reliability and validity of the Outcome and Assessment information set. 2)differentiate the different types of validity and reliability tested 3)describe the gaps in knowledge related to reliability and validity of the OASIS

Keywords: Home Care, Medicare

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a professor, researcher and policy analyst with over 20 years experience in gerontological health and long term care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.