养老院工作人员的变化和质量:评估日常工作人员水平变化的替代措施
Christopher S Brunt1, John R Bowblis2
1Department of Economics, Georgia Southern University, Statesboro, GA, USA.
Journal of the American Medical Directors Association
|March 2, 2025
概括
基于中位数的指标,特别是中位数CDMAD,最能预测养老院质量结果. 将日常人员变化纳入医疗保险和医疗补助中心.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 养老院的质量 养老院的质量
背景情况:
- 每日护理人员的变化与养老院的质量有关.
- 现有呼吁包括在医疗保险和医疗补助中心 (CMS) 的员工星级评级中的员工变化.
- 为了评估质量结果,需要对人员变化的最佳测量.
研究的目的:
- 评估六种不同的每日护理人员员工水平变化指标.
- 确定解释养老院质量结果的最有效措施.
- 为了确定一个最佳的变化度量,将其纳入CMS员工星级评级.
主要方法:
- 来自CMS Care Compare和基于工资的期刊 (2022Q1-2023Q3) 的二次数据的分析.
- 对六个变化指标的评估:CV,TOD,LOD,CQV,平均CDMAD和中位CDMAD.
- 使用线性回归对9个基于患者的质量结果进行统计学有效性评估,检查显著性,相关性,适合性和单调性.
主要成果:
- 中位数-CDMAD显示出优越的统计性质,在56%-67%的质量结果中达到最佳的适合性.
- 中位CDMAD,平均CDMAD和CV显示出优越的单调性,表明对异常值和游戏的稳定性.
- 这些基于中位数的指标在解释质量结果方面显示出比其他指标更大的有效性.
结论:
- 基于中位数的变化指标,特别是中位数-CDMAD,对于预测养老院质量非常有效.
- 这些措施适合CMS员工星级评级系统.
- 包括日常人员变化可以提高透明度,并激励养老院的质量改善.
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