Rasch analysis of Minimum Data Set mandated in skilled nursing facilities

Area of Science:

• Gerontology
• Health Services Research
• Psychometrics

Background:

• The Minimum Data Set (MDS) is a federally mandated assessment tool used in long-term care facilities.
• Assessing the construct validity of MDS scales is crucial for ensuring accurate patient evaluation.
• Physical functioning and cognition are key domains assessed by the MDS.

Purpose of the Study:

• To examine the construct validity of the physical functioning and cognition scales within the Minimum Data Set (MDS).
• To evaluate the psychometric properties of MDS items using Rasch analysis.

Main Methods:

• Secondary analysis of retrospective Minimum Data Set (MDS) data from the Department of Veteran Affairs.
• Application of Rasch analysis to assess unidimensionality and psychometric properties of physical functioning and cognition items.

Main Results:

• MDS items demonstrated unidimensionality, representing distinct physical functioning and cognition constructs.
• The physical functioning scale exhibited good psychometric properties, efficiently discriminating resident performance across strata.
• The cognition scale showed weaker psychometric properties, with significant ceiling effects and limited discrimination.

Conclusions:

• The construct validity of the Minimum Data Set (MDS) physical functioning and cognition scales is generally supported.
• The physical functioning scale is a robust measure, while the cognition scale requires refinement.
• Future research should focus on improving the cognition scale's rating function and item difficulty.