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Deriving a risk-adjustment model for pressure ulcer development using the Minimum Data Set.

D R Berlowitz1, G H Brandeis, J N Morris

  • 1Sections of General Internal Medicine and Geriatrics, Boston Medical Center, Boston, Massachusetts, USA.

Journal of the American Geriatrics Society
|August 31, 2001
PubMed
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A risk-adjustment model was developed using the Minimum Data Set (MDS) to predict pressure ulcer development in nursing home residents. This model can help assess nursing home quality by identifying at-risk individuals.

Area of Science:

  • Gerontology
  • Nursing Home Quality Assessment
  • Clinical Risk Prediction

Background:

  • Pressure ulcers are a significant concern in nursing home care, impacting resident well-being and healthcare costs.
  • Accurate risk assessment is crucial for implementing preventive strategies and improving care quality.

Purpose of the Study:

  • To develop and validate a risk-adjustment model for pressure ulcer development using the Minimum Data Set (MDS).
  • To assess the utility of this model for evaluating the quality of nursing home care.

Main Methods:

  • An observational study utilizing MDS data from 39,649 nursing home resident assessments.
  • A multivariate logistic regression model was developed to identify predictors of pressure ulcer development.
  • Pressure ulcer status was assessed approximately 90 days post-index assessment.

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Main Results:

  • A stage 2 or larger pressure ulcer developed in 2.3% of observations.
  • Seventeen resident characteristics, including mobility dependence, diabetes, and incontinence, were significant predictors.
  • The derived risk-adjustment model demonstrated good calibration and discrimination (c-statistic = 0.73).

Conclusions:

  • A clinically valid risk-adjustment model for pressure ulcer development can be created using MDS data.
  • This model shows promise for profiling nursing homes based on their pressure ulcer incidence rates.