MDS-based state medicaid reimbursement and the ADL-decline quality indicator
MDS-based state medicaid reimbursement and the ADL-decline quality indicator
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DOI：
10.1093/geront/48.3.324
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发表时间：
2008-06-01
期刊：
影响因子：
5.7
通讯作者：
Halpin, Helen A.
中科院分区：
文献类型：
--
作者：
Bellows, Nicole M.;Halpin, Helen A.
目的：我们研究了日常生活活动（ADL）下降的质量指标与使用最小数据集（MDS）确定医疗补助熟练护理设施报销之间的关系。设计和方法：我们使用2004年国家MDS设施质量指标报告作为多水平回归模型中的因变量进行了横断面分析。我们的主要解释变量是一个州一级的二元变量区分是否使用基于MDS的医疗补助报销系统在2004年的国家。我们通过在线调查、认证和报告系统获得控制变量。结果如下：位于使用MDS进行医疗补助报销的州的熟练护理设施报告的ADL下降比不使用MDS进行报销的州的设施多。影响：这一发现表明，ADL下降质量指标捕捉的不仅仅是质量，包括国家层面的政策差异。因此，在依赖于按业绩计薪计划之前，应调查和完善ADL下降质量指标。
Purpose: We examined the relationship between the quality indicator for decline in activities of daily living (ADL) and the use of the Minimum Data Set (MDS) for determining Medicaid skilled nursing facility reimbursement. Design and Methods: We conducted a cross-sectional analysis using the 2004 National MDS Facility Quality Indicator reports as the dependent variable in a multilevel regression model. Our primary explanatory variable was a state-level binary variable distinguishing whether or not the state used an MDS-based Medicaid-reimbursement system in 2004. We obtained control variables through the Online Survey, Certification, and Reporting System. Results: Skilled nursing facilities located in states that used the MDS for Medicaid reimbursement reported more ADL decline than did facilities in states that did not use the MDS for reimbursement. Implications: The finding suggests that the ADL-decline quality indicator captures more than just quality, including state-level policy differences. Therefore, the ADL-decline quality indicator should be investigated and refined prior to being relied on for pay-for-performance initiatives.