Alternative Risk-Adjustment Approaches to Assessing the Quality of Home Health Care: Final Report. NOTES


  1. Because of data constraints and methodological issues, 11 outcomes are not risk-adjusted. CMS is planning to address these constraints and issues so that these outcomes will be either risk-adjusted or modified so risk-adjustment is possible.

  2. CMS has tested several other risk-adjustment methods (e.g., multivariate standardization, discriminant function analysis, the classification and regression tree methodology). Logistic regression was determined to have several advantages over these methods, and thus, adopted for use.

  3. As of September 1, 2005, four of the initial 11 HHQI indicators were dropped from public reporting (i.e., Improvement in Toileting, Improvement in Upper Body Dressing, Improvement in Confusion Frequency, and Stabilization in Bathing). They were replaced by Improvement in Dyspnea, Improvement in Urinary Incontinence, and Discharge to the Community.

  4. Regression results for the core model (Model 1) and Model 2 are available from the project team upon request.

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