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Related Experiment Videos

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

D R Berlowitz1, G H Brandeis, J J Anderson

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

Journal of the American Geriatrics Society
|August 31, 2001
PubMed
Summary

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This study validated a risk-adjustment model for pressure ulcer development in nursing homes. The model performed well, showing significant differences in expected ulcer rates and impacting outlier identification.

Area of Science:

  • Gerontology
  • Nursing Science
  • Health Services Research

Background:

  • Pressure ulcers are a significant concern in nursing home care.
  • Accurate risk adjustment is crucial for evaluating nursing home performance.
  • Previous models require validation in diverse populations.

Purpose of the Study:

  • To validate a risk-adjustment model for pressure ulcer development.
  • To assess the impact of this model on nursing home performance judgments.

Main Methods:

  • Retrospective observational study using 1998 Minimum Data Set (MDS) data.
  • Logistic regression analysis on 13,457 nursing home residents.
  • Comparison of unadjusted and risk-adjusted outlier identification.

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Main Results:

  • The risk-adjustment model showed similar predictor effects and unchanged c-statistic (0.73) in the validation sample.
  • Expected pressure ulcer rates varied significantly (1.1%–3.2%) across 108 nursing homes.
  • Outlier identification differed between unadjusted and risk-adjusted performance metrics.

Conclusions:

  • The MDS risk-adjustment model for pressure ulcer development is effective in a new sample.
  • Nursing homes exhibit substantial variation in expected pressure ulcer development rates.
  • Risk adjustment influences the identification of outlier nursing homes.