Alternative Risk-Adjustment Approaches to Assessing the Quality of Home Health Care: Final Report. TABLE 11b: Final Alternative Risk-Adjustment Models for Utilization Outcomes

07/01/2006

TABLE 11b. Final Alternative Risk-Adjustment Models for Utilization Outcomes
Risk Factor Measured at SOC/ROC Acute Care Hospitalization Discharged to Community Emergent Care
Full Model Full Model Full Model
Coef. p Coef. p Coef. p
DEMOGRAPHICS
Age lt 65  0.159   0.000   -0.127   0.000   0.159   0.000 
Age 75-84 -0.025 0.050 0.012 0.347 -0.010 0.440
Age 85+ -0.068 0.000 0.028 0.055 -0.005 0.754
Gender: female -0.029 0.004 0.035 0.000 -0.003 0.760
SOCIOECONOMIC FACTORS
Any Medicaid 0.228 0.000 -0.226 0.000 0.213 0.000
Medicare HMO -0.319 0.000 0.296 0.000 -0.154 0.000
PRIOR SERVICE USE
Discharged past 14 days:
Discharge from hospital 0.282 0.000 -0.249 0.000 0.307 0.000
Discharge from rehab facility -0.027 0.136 0.012 0.495 -0.031 0.116
Discharge from nursing home 0.077 0.000 -0.113 0.000 0.106 0.000
CLINICAL FACTORS
Prognoses
Overall prognosis good/fair -0.171 0.000 0.399 0.000 -0.159 0.000
Rehabilitation prognosis good -0.363 0.000 0.400 0.000 -0.300 0.000
Diagnoses
Diabetes (PPS Group) 0.256 0.000 -0.251 0.000 0.192 0.000
Orthopedic (PPS Group) -0.199 0.000 0.199 0.000 -0.149 0.000
Neurological (PPS Group) -0.214 0.000 0.207 0.000 -0.156 0.000
Wound/Burn (PPS Group) 0.196 0.000 -0.215 0.000 0.071 0.002
Cancer 0.340 0.000 -0.507 0.000 0.231 0.000
Mental condition 0.067 0.004 -0.052 0.025 0.079 0.001
Dementia -0.224 0.000 0.172 0.000 -0.132 0.000
Hypertension -0.063 0.000 0.083 0.000 -0.049 0.000
Ischemia 0.048 0.001 -0.032 0.031 0.107 0.000
Arrhythmia 0.055 0.001 -0.051 0.002 0.060 0.001
Heart failure 0.287 0.000 -0.276 0.000 0.247 0.000
COPD 0.101 0.000 -0.079 0.000 0.138 0.000
Skin ulcer 0.135 0.000 -0.130 0.000 0.044 0.043
Orthopedic (other than PPS) -0.326 0.000 0.315 0.000 -0.243 0.000
Incontinence 0.139 0.000 -0.171 0.000 0.064 0.028
Symptoms, signs, & ill-defined conditions -0.048 0.005 0.042 0.011 0.006 0.740
Diagnosis Severity
Number of severity ratings >2 0.130 0.000 -0.129 0.000 0.090 0.000
Sensory Status
Partially vision impaired 0.043 0.000 -0.043 0.000 0.021 0.074
Severely vision impaired 0.040 0.163 -0.029 0.316 0.022 0.475
Speech: Minimum difficulty 0.009 0.521 -0.014 0.303 0.011 0.458
Speech: Moderate difficulty -0.055 0.019 0.069 0.003 0.007 0.790
Speech: Severe difficulty/unable/non-responsive (Levels 3-5) -0.034 0.247 0.067 0.023 0.020 0.523
Integrumentary Status
Surgical wound present -0.278 0.000 0.315 0.000 -0.246 0.000
Stage of most problematic pressure ulcer 0.183 0.000 -0.207 0.000 0.108 0.000
Status of most problematic stasis ulcer 0.249 0.000 -0.254 0.000 0.146 0.000
Functional Status/Physical Functioning
ADL/IADL index 0.069 0.000 -0.081 0.000 0.057 0.000
Elimination Status
Urinary incontinence during the night -0.063 0.001 0.069 0.000 -0.020 0.330
Urinary incontinence during the day -0.091 0.008 0.115 0.001 -0.049 0.177
Urinary incontinence during the night & day -0.011 0.435 0.016 0.255 0.002 0.910
Urinary catheter present 0.534 0.000 -0.618 0.000 0.392 0.000
Bowel incontinent less than weekly 0.053 0.068 -0.072 0.012 0.069 0.023
Bowel incontinent 1-3 times/week 0.088 0.000 -0.111 0.000 0.034 0.188
Bowel incontinent 4-6 times/week 0.146 0.000 -0.162 0.000 0.113 0.001
Bowel incontinent daily or more often 0.205 0.000 -0.216 0.000 0.141 0.000
Ostomy 0.292 0.000 -0.297 0.000 0.162 0.000
Neuro/Emotional/Behavioral Status
Cog Func: Requires prompting 0.025 0.100 -0.036 0.017 -0.006 0.728
Cog Func: Requires assistance & some direction -0.055 0.017 0.016 0.475 -0.057 0.020
Cog Func: Requires considerable assistance -0.147 0.000 0.057 0.111 -0.131 0.001
Cog Func: Totally dependent -0.189 0.003 0.137 0.031 -0.148 0.029
Conf Freq: In new situations 0.084 0.000 -0.102 0.000 0.091 0.000
Conf Freq: Awakening at night 0.119 0.001 -0.146 0.000 0.154 0.000
Conf Freq: Day/evenings, not constant 0.064 0.004 -0.107 0.000 0.052 0.027
Conf Freq: Constantly 0.021 0.610 -0.028 0.495 -0.008 0.849
Anx Freq: Less than daily 0.066 0.000 -0.062 0.000 0.078 0.000
Anx Freq: Daily but not constantly 0.130 0.000 -0.144 0.000 0.143 0.000
Anx Freq: All the time 0.175 0.000 -0.170 0.000 0.215 0.000
Verbal disruption 0.042 0.271 -0.057 0.132 0.070 0.073
Depressive Feelings: Depressed mood 0.121 0.000 -0.152 0.000 0.091 0.000
Depressive Feelings: Any other elements (2-6) 0.188 0.000 -0.250 0.000 0.155 0.000
OUTCOME SPECIFIC RISK-ADJUSTERS
Dyspnea when walking/climbing stairs 0.145 0.000 -0.137 0.000 0.147 0.000
Dyspnea when moderate exertion 0.276 0.000 -0.275 0.000 0.238 0.000
Dyspnea with minimum exertion 0.469 0.000 -0.481 0.000 0.368 0.000
Dyspnea when at rest 0.643 0.000 -0.674 0.000 0.522 0.000
Clinical Factors: Therapies
IV/Infusion therapy 0.489 0.000 -0.476 0.000 0.328 0.000
Ventilator 0.044 0.742 0.043 0.753 0.017 0.904
 
Intercept -1.947 0.000 1.628 0.000 -2.104 0.000
R2 statistic 0.125   0.153   0.075  
c statistic 0.719   0.732   0.683  

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