Alternative Risk-Adjustment Approaches to Assessing the Quality of Home Health Care: Final Report. TABLE 9b: Final Alternative Risk-Adjustment Models for Emotional/Behavioral Outcomes

07/01/2006

TABLE 9b. Final Alternative Risk-Adjustment Models for Emotional/Behavioral Outcomes
Risk Factor Measured at SOC/ROC Improvement in: Stabilization in:
Anxiety Behavioral Problem Frequency Anxiety
Core Only Core Only Core Only
Coef. p Coef. p Coef. p
DEMOGRAPHICS
Age lt 65  -0.158   0.000   -0.292   0.000   -0.136   0.000 
Age 75-84 0.057 0.006 -0.124 0.031 0.005 0.817
Age 85+ 0.079 0.001 -0.191 0.002 0.071 0.002
Gender: female -0.205 0.000 0.055 0.187 -0.359 0.000
SOCIOECONOMIC FACTORS
Any Medicaid -0.014 0.610 -0.117 0.079 0.116 0.000
Medicare HMO 0.122 0.000 0.089 0.217 0.065 0.009
PRIOR SERVICE USE
Discharged past 14 days:
Discharge from hospital 0.165 0.000 0.276 0.000 0.044 0.014
Discharge from rehab facility 0.317 0.000 0.458 0.000 0.041 0.118
Discharge from nursing home 0.141 0.000 0.202 0.006 -0.011 0.714
CLINICAL FACTORS
Prognoses
Overall prognosis good/fair 0.108 0.001 0.050 0.433 0.110 0.001
Rehabilitation prognosis good 0.180 0.000 0.036 0.466 0.153 0.000
Diagnoses
Diabetes (PPS Group) 0.042 0.043 -0.062 0.239 0.065 0.001
Orthopedic (PPS Group) 0.082 0.000 -0.027 0.550 0.155 0.000
Neurological (PPS Group) 0.010 0.670 -0.027 0.563 -0.025 0.243
Wound/Burn (PPS Group) -0.070 0.061 -0.029 0.756 -0.058 0.098
Cancer -0.118 0.000 0.080 0.400 -0.195 0.000
Mental condition -0.293 0.000 -0.152 0.013 -0.515 0.000
Dementia -0.044 0.298 -0.064 0.262 -0.120 0.006
Hypertension 0.038 0.036 0.062 0.187 0.072 0.000
Ischemia -0.002 0.934 -0.013 0.854 0.000 0.993
Arrhythmia 0.022 0.443 0.115 0.135 -0.040 0.145
Heart failure -0.032 0.187 0.008 0.897 -0.022 0.348
COPD -0.181 0.000 -0.057 0.434 -0.210 0.000
Skin ulcer 0.057 0.144 -0.071 0.457 0.062 0.087
Orthopedic (other than PPS) 0.078 0.000 0.008 0.884 0.200 0.000
Incontinence 0.017 0.731 -0.260 0.004 0.100 0.060
Symptoms, signs, & ill-defined conditions -0.016 0.559 0.002 0.969 0.075 0.005
Diagnosis Severity
Number of severity ratings >2 -0.020 0.001 -0.004 0.794 -0.062 0.000
Sensory Status
Partially vision impaired -0.065 0.000 -0.050 0.232 -0.014 0.466
Severely vision impaired -0.111 0.027 0.083 0.396 -0.014 0.775
Speech: Minimum difficulty -0.059 0.008 -0.123 0.031 -0.065 0.005
Speech: Moderate difficulty -0.086 0.021 -0.041 0.557 -0.167 0.000
Speech: Severe difficulty -0.111 0.025 0.009 0.916 -0.210 0.000
Integumentary Status
Surgical wound present 0.097 0.000 -0.033 0.590 0.169 0.000
Stage of most problematic pressure ulcer -0.027 0.152 -0.010 0.811 -0.040 0.026
Status of most problematic stasis ulcer -0.024 0.318 0.011 0.855 -0.039 0.071
Functional Status/ Physical Functioning
ADL/IADL index 0.021 0.000 -0.021 0.014 -0.014 0.000
Elimination Status
Urinary incontinence during the night -0.066 0.021 -0.056 0.427 -0.053 0.075
Urinary incontinence during the day -0.078 0.141 -0.030 0.775 0.039 0.472
Urinary incontinence during the night & day -0.149 0.000 -0.121 0.023 -0.013 0.592
Urinary catheter present -0.184 0.000 -0.077 0.466 -0.070 0.079
Bowel incontinent less than weekly -0.003 0.951 -0.048 0.585 -0.106 0.030
Bowel incontinent 1-3 times/week 0.010 0.808 -0.079 0.273 -0.027 0.540
Bowel incontinent 4-6 times/week -0.026 0.672 -0.045 0.634 0.018 0.782
Bowel incontinent daily or more often 0.015 0.757 0.022 0.770 0.053 0.261
Ostomy -0.011 0.850 0.055 0.742 -0.223 0.000
Neuro/Emotional/Behavioral Status
Cog Func: Requires prompting -0.122 0.000 -0.236 0.001 -0.053 0.035
Cog Func: Requires assistance & some direction -0.241 0.000 -0.352 0.000 -0.071 0.072
Cog Func: Requires considerable assistance -0.339 0.000 -0.535 0.000 -0.049 0.422
Cog Func: Totally dependent -0.465 0.000 -0.648 0.000 -0.004 0.970
Conf Freq: In new situations -0.165 0.000 0.014 0.847 -0.158 0.000
Conf Freq: Awakening at night -0.153 0.005 -0.023 0.854 -0.293 0.000
Conf Freq: Day/evenings, not constant -0.122 0.001 -0.153 0.063 -0.177 0.000
Conf Freq: Constantly -0.118 0.065 -0.449 0.000 -0.209 0.003
Anx Freq: Less than daily     -0.218 0.000 0.803 0.000
Anx Freq: Daily but not constantly 0.672 0.000 -0.118 0.023 2.863 0.000
Anx Freq: All the time 1.651 0.000 -0.202 0.040    
Verbal disruption -0.313 0.000 -0.149 0.007 -0.418 0.000
Behav Prob Freq: Once a month     0.113 0.341    
Behav Prob Freq: Several times a month     -0.106 0.179    
Behav Prob Freq: Several times a week     -0.046 0.508    
Behav Prob Freq: At least daily     -0.019 0.770    
Depressive Feelings: Depressed mood -0.182 0.000 0.000 1.000 -0.369 0.000
Depressive Feelings: Any other elements (2-6) -0.397 0.000 0.060 0.415 -0.575 0.000
 
Intercept -0.274 0.000 1.336 0.000 1.889 0.000
R2 statistic 0.058   0.057   0.045  
c statistic 0.637   0.639   0.683  

View full report

Preview
Download

"qualHH.pdf" (pdf, 3.72Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®