Alternative Risk-Adjustment Approaches to Assessing the Quality of Home Health Care: Final Report. TABLE 8a: Summary of Regression Models: Physiologic Measures

07/01/2006

TABLE 8a. Summary of Regression Models: Physiologic Measures
  Risk-Adjusted in OBQI or HHQI University of Colorado Model Model 1 Clinical Core (Baseline Model) Model 2 Adds Outcome-Specific Model 3 Adds OASIS “Prior” Items
IMPROVEMENT IN PAIN Yes  
Percent Who Could Improve: 44.4%
Percent Improving Among Those Who Could: 56.2%
Number of OASIS Items   40 42 43 45a
Number of OASIS Elements   65 60 61 64
R2 statistic   0.065 0.053 0.056 0.058
c statistic   0.643 0.630 0.633 0.635
IMPROVEMENT IN NUMBER OF SURGICAL WOUNDS No  
Percent Who Could Improve: 21.9%
Percent Improving Among Those Who Could: 59.3%
Number of OASIS Items   N/A 42    
Number of OASIS Elements     60    
R2 statistic     0.047    
c statistic     0.627    
IMPROVEMENT IN STATUS OF SUGICAL WOUNDS No  
Percent Who Could Improve: 22.9%
Percent Improving Among Those Who Could: 75.0%
Number of OASIS Items   N/A 42    
Number of OASIS Elements     60    
R2 statistic     0.065    
c statistic     0.670    
IMPROVEMENT IN DYSPNEA Yes  
Percent Who Could Improve: 44.2%
Percent Improving Among Those Who Could: 53.3%
Number of OASIS Items   57 42 44 b
Number of OASIS Elements   85 60 66  
R2 statistic   0.114 0.098 0.110  
c statistic   0.695 0.680 0.690  
IMPROVEMENT IN URINARY TRACT INFECTION Yes  
Percent Who Could Improve: 6.0%
Percent Improving Among Those Who Could: 83.7%
Number of OASIS Items   18 41 43 45c
Number of OASIS Elements   32 59 63 67
R2 statistic   0.121 0.048 0.059 0.059
c statistic   0.740 0.658 0.665 0.665
IMPROVEMENT IN URINARY INCONTINENCE Yes  
Percent Who Could Improve: 20.7%
Percent Improving Among Those Who Could: 49.0%
Number of OASIS Items   53 41 43 46d
Number of OASIS Elements   55 59 65 72
R2 statistic   0.119 0.088 0.092 0.103
c statistic   0.696 0.667 0.670 0.682
IMPROVEMENT IN BOWEL INCONTINENCE Yes  
Percent Who Could Improve: 7.0%
Percent Improving Among Those Who Could: 59.1%
Number of OASIS Items   37 41 43 46d
Number of OASIS Elements   55 59 65 72
R2 statistic   0.141 0.117 0.126 0.131
c statistic   0.719 0.700 0.707 0.711
IMPROVEMENT IN SPEECH No  
Percent Who Could Improve: 21.2$
Percent Improving Among Those Who Could: 43.3%
Number of OASIS Items   N/A 41    
Number of OASIS Elements     59    
R2 statistic     0.080    
c statistic     0.665    
STABILIZATION IN SPEECH No  
Percent Who Could Stabilize: 70.0%
Percent Stabilized Among Those Who Could: 91.0%
Number of OASIS Items   N/A 41    
Number of OASIS Elements     59    
R2 statistic     0.085    
c statistic     0.742    
NOTES: “Percent Who Could Improve” calculated using all home health episodes, not just those discharged to the community. The smallest sample size for the Physiologic risk-adjustment models is 27,248. Shading indicates that U of CO model statistics are for multiple sub-models; we report the number of unique OASIS items and elements across all sub-models.
  1. Risk-adjustment model includes presence of intractable pain prior to home health admission.
  2. There are no “prior” items for inclusion in the dyspnea risk-adjustment model.
  3. Risk-adjustment model includes presence of urinary incontinence and indwelling/suprapubic catheter prior to home health admission.
  4. Risk-adjustment model includes help required with toileting prior to home health admission as well as presence of urinary incontinence, indwelling/suprapubic catheter, impaired decision making, and memory loss prior to home health admission.

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