Deriving a risk-adjustment model for pressure ulcer development using the Minimum Data Set
Authors
Berlowitz, Dan R.Brandeis, Gary H.
Morris, John N.
Ash, Arlene S.
Anderson, Jennifer J.
Kader, Boris
Moskowitz, Mark A.
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2001-08-31Keywords
AgedBody Mass Index
*Data Collection
*Databases, Factual
*Geriatric Assessment
Health Services Research
Humans
Logistic Models
*Models, Statistical
Multivariate Analysis
Nursing Homes
Predictive Value of Tests
Pressure Ulcer
*Risk Adjustment
Risk Factors
Southeastern United States
Urinary Incontinence
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
OBJECTIVE: To use the Minimum Data Set (MDS) to derive a risk-adjustment model for pressure ulcer development that may be used in assessing the quality of nursing home care. DESIGN: Perspective observational study using MDS data from 1997. SETTING: A large, for-profit, nursing home chain. PARTICIPANTS: Our unit of analysis was 39,649 observations made on 14,607 nursing home residents who were without a stage 2 or larger pressure ulcer on an index assessment. MEASUREMENTS: Pressure ulcer status was determined at an outcome assessment approximately 90 days after an index assessment. Potential predictors of pressure ulcer development were examined for bivariate associations, contributing to the development of a multivariate logistic regression model. RESULTS: A stage 2 or larger pressure ulcer developed in 2.3% of the observations. Seventeen resident characteristics were found to be associated with pressure ulcer development. These included dependence in mobility and transferring, diabetes mellitus, peripheral vascular disease, urinary incontinence, lower body mass index, and end-stage disease. A risk-adjustment model based on these characteristics was well calibrated and able to discriminate among residents with different levels of risk for ulcer development (model c-statistic = 0.73). CONCLUSION: A clinically credible risk-adjustment model with good performance properties can be developed using the MDS. This model may be useful in profiling nursing homes on their rate of pressure ulcer development.Source
J Am Geriatr Soc. 2001 Jul;49(7):866-71. Link to article on publisher's siteDOI
10.1046/j.1532-5415.2001.49175.xPermanent Link to this Item
http://hdl.handle.net/20.500.14038/47569PubMed ID
11527476Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1046/j.1532-5415.2001.49175.x