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Risk Adjustment, Mode Adjustment, and Nonresponse Bias Analysis on Quality Measures From a Long-Term Care Hospital Experience of Care Survey
Archives of Physical Medicine and Rehabilitation ( IF 3.6 ) Pub Date : 2020-05-01 , DOI: 10.1016/j.apmr.2019.11.016
Sara M. Zuckerbraun , Anne Deutsch , Celia Eicheldinger , Alicia M. Frasier , John D. Loft , Joseph B. Clift

OBJECTIVES To develop a patient risk adjustment model for experience of care (EOC) quality measures for long-term care hospitals (LTCHs) that includes mode of survey administration. To assess presence of nonresponse bias in the adjusted facility-level scores. DESIGN Tested three modes of collecting the EOC data: mail-only, mixed (i.e., mail with telephone follow-up), and in-facility. Used sequential modeling and impact analysis, specified a risk and mode adjustment model and evaluated presence of non-response after adjustment. SETTING Long-term care hospitals PARTICIPANTS: 1,364 patients and 69 LTCHs. INTERVENTION Not applicable MAIN OUTCOME MEASURES: Risk and mode adjusted responses to twenty-eight survey questions and six facility-level scores derived from survey responses. RESULTS Mode of data collection, and patient risk variables of age, sex, overall health, overall mental health, marital status, education, race, and whether a proxy responded were significant were included in the model. Clinical variables were not significant. The in-facility mode was associated with significantly higher performance scores than the other modes. When the recommended risk and mode adjustment model was applied, nonresponse bias was not observed in any mode. CONCLUSIONS LTCH EOC data should be adjusted for patient risk variables including mode of data collection.

中文翻译:

长期护理医院护理体验调查中质量措施的风险调整、模式调整和无响应偏差分析

目标 为长期护理医院 (LTCH) 的护理体验 (EOC) 质量措施开发患者风险调整模型,其中包括调查管理模式。评估调整后的设施级别分数中是否存在无响应偏差。设计 测试了三种收集 EOC 数据的模式:仅邮件、混合(即邮件与电话跟进)和在设施内。使用顺序建模和影响分析,指定风险和模式调整模型,并评估调整后的无响应情况。设置长期护理医院参与者:1,364 名患者和 69 名 LTCH。干预 不适用 主要结果测量:对 28 个调查问题的风险和模式调整后的回答和从调查回答中得出的 6 个设施级别的分数。结果 数据收集方式,以及年龄、性别、模型中包括整体健康、整体心理健康、婚姻状况、教育、种族以及代理响应是否显着。临床变量不显着。设施内模式的性能得分明显高于其他模式。当应用推荐的风险和模式调整模型时,在任何模式下都没有观察到无反应偏差。结论 LTCH EOC 数据应根据患者风险变量(包括数据收集模式)进行调整。当应用推荐的风险和模式调整模型时,在任何模式下都没有观察到无反应偏差。结论 LTCH EOC 数据应根据患者风险变量(包括数据收集模式)进行调整。当应用推荐的风险和模式调整模型时,在任何模式下都没有观察到无反应偏差。结论 LTCH EOC 数据应根据患者风险变量(包括数据收集模式)进行调整。
更新日期:2020-05-01
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