Alternative Risk-Adjustment Approaches to Assessing the Quality of Home Health Care: Final Report. TABLE 10b: Final Alternative Risk-Adjustment Models for Cognitive Outcomes

07/01/2006

TABLE 10b. Final Alternative Risk-Adjustment Models for Cognitive Outcomes
Risk Factor Measured at SOC/ROC Improvement in: Stabilization In:
Confusion Frequency Cognitive Functioning Cognitive Functioning
Full Model Core Only Core Only
Coef. p Coef. p Coef. p
DEMOGRAPHICS
Age lt 65  0.038   0.144   -0.097   0.001   0.114   0.000 
Age 75-84 -0.165 0.000 -0.120 0.000 -0.324 0.000
Age 85+ -0.336 0.000 -0.274 0.000 -0.629 0.000
Gender: female -0.071 0.000 -0.026 0.064 0.004 0.766
SOCIOECONOMIC FACTORS
Any Medicaid -0.078 0.000 -0.094 0.000 -0.050 0.026
Medicare HMO 0.084 0.000 0.044 0.053 -0.042 0.036
PRIOR SERVICE USE
Discharged past 14 days:
Discharge from hospital 0.325 0.000 0.365 0.000 0.194 0.000
Discharge from rehab facility 0.474 0.000 0.432 0.000 0.084 0.000
Discharge from nursing home 0.203 0.000 0.193 0.000 -0.010 0.650
CLINICAL FACTORS
Prognoses
Overall prognosis good/fair 0.133 0.000 0.146 0.000 0.225 0.000
Rehabilitation prognosis good 0.123 0.000 0.099 0.000 0.125 0.000
Diagnoses
Diabetes (PPS Group) -0.017 0.277 0.034 0.040 -0.056 0.001
Orthopedic (PPS Group) 0.096 0.000 0.086 0.000 0.088 0.000
Neurological (PPS Group) -0.097 0.000 -0.133 0.000 -0.263 0.000
Wound/Burn (PPS Group) -0.123 0.000 -0.044 0.171 -0.073 0.015
Cancer -0.057 0.022 0.028 0.306 -0.167 0.000
Mental condition -0.128 0.000 -0.243 0.000 -0.462 0.000
Dementia -0.444 0.000 -0.463 0.000 -0.709 0.000
Hypertension 0.027 0.051 0.052 0.000 0.092 0.000
Ischemia 0.065 0.001 0.082 0.000 0.157 0.000
Arrhythmia 0.020 0.342 0.026 0.243 -0.041 0.059
Heart failure -0.042 0.017 0.030 0.122 0.011 0.558
COPD 0.006 0.748 0.058 0.008 0.110 0.000
Skin ulcer -0.039 0.192 -0.096 0.003 -0.073 0.013
Orthopedic (other than PPS) 0.074 0.000 0.060 0.001 0.247 0.000
Incontinence -0.089 0.010 -0.084 0.017 0.001 0.969
Symptoms, signs, & ill-defined conditions -0.035 0.065 -0.049 0.015 -0.084 0.000
Diagnosis Severity
Number of severity ratings >2 0.016 0.001 0.016 0.001 -0.017 0.001
Sensory Status
Partially vision impaired -0.044 0.001 -0.031 0.025 0.003 0.810
Severely vision impaired -0.053 0.123 -0.059 0.097 -0.073 0.045
Speech: Minimum difficulty -0.194 0.000 -0.336 0.000 -0.562 0.000
Speech: Moderate difficulty -0.290 0.000 -0.603 0.000 -0.959 0.000
Speech: Severe difficulty -0.440 0.000 -0.965 0.000 -1.290 0.000
Integumentary Status
Surgical wound present 0.191 0.000 0.216 0.000 0.484 0.000
Stage of most problematic pressure ulcer -0.021 0.147 0.001 0.956 -0.016 0.266
Status of most problematic stasis ulcer 0.007 0.684 0.020 0.294 0.027 0.133
Functional Status/Physical Functioning
ADL/IADL index -0.011 0.000 -0.038 0.000 -0.102 0.000
Elimination Status
Urinary incontinence during the night -0.160 0.000 -0.168 0.000 -0.159 0.000
Urinary incontinence during the day -0.224 0.000 -0.311 0.000 -0.197 0.000
Urinary incontinence during the night & day -0.193 0.000 -0.235 0.000 -0.171 0.000
Urinary catheter present -0.169 0.000 -0.129 0.000 0.012 0.715
Bowel incontinent less than weekly -0.073 0.021 -0.073 0.026 -0.061 0.091
Bowel incontinent 1-3 times/week -0.134 0.000 -0.132 0.000 -0.142 0.000
Bowel incontinent 4-6 times/week -0.223 0.000 -0.319 0.000 -0.276 0.000
Bowel incontinent daily or more often -0.181 0.000 -0.225 0.000 -0.354 0.000
Ostomy 0.023 0.623 0.060 0.262 -0.035 0.457
Neuro/Emotional Behavioral Status
Cog Func: Requires prompting -0.395 0.000     1.400 0.000
Cog Func: Requires assistance & some direction -0.617 0.000 0.970 0.000 2.552 0.000
Cog Func: Requires considerable assistance -0.901 0.000 1.782 0.000 3.902 0.000
Cog Func: Totally dependent -1.486 0.000 2.527 0.000    
Conf Freq: In new situations     -0.366 0.000 -0.632 0.000
Conf Freq: Awakening at night 1.393 0.000 -0.484 0.000 -0.785 0.000
Conf Freq: Day/evenings, not constant 1.243 0.000 -0.823 0.000 -1.287 0.000
Conf Freq: Constantly 1.908 0.000 -1.322 0.000 -1.811 0.000
Anx Freq: Less than daily -0.070 0.000 -0.004 0.790 -0.013 0.400
Anx Freq: Daily but not constantly -0.021 0.201 0.045 0.011 -0.022 0.244
Anx Freq: All the time 0.094 0.022 0.176 0.000 0.031 0.539
Verbal disruption -0.240 0.000 -0.284 0.000 -0.291 0.000
Depressive Feelings: Depressed mood 0.016 0.274 0.033 0.035 -0.038 0.016
Depressive Feelings: Any other elements (2-6) 0.078 0.014 0.079 0.018 0.036 0.338
OUTCOME SPECIFIC RISK-ADJUSTERS
Memory deficit -0.207 0.000        
Impaired decision making -0.096 0.000        
Status Prior to Admission
Impaired decision making prior 2 weeks -0.190 0.000        
Disruptive behavior prior 2 weeks -0.109 0.010        
Memory loss prior 2 weeks -0.212 0.000        
 
Intercept -0.155 0.000 0.189 0.000 2.922 0.000
R2 statistic 0.097   0.082   0.078  
c statistic 0.680   0.665   0.738  

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