Categorizing Nursing Homes Based on Quality Performance

描述(由申请人提供)：最小数据集(MDS)养老院质量指标(QI)已被各种受众用于各种目的。然而，尽管进行了漫长而紧张的审查，如何使用质量指标来得出关于养老院的结论的概念仍处于初级阶段。研究人员倾向于使用大量的测量方法，而不关注它们是如何协同工作的，也很少对如何使用它们来比较一个设施和另一个设施发表评论。 该项目旨在通过根据养老院的质量方面的表现对养老院进行分类来解决其中的一些不足。这项研究可以帮助目前将疗养院补偿与质量激励联系起来的努力，并向消费者提供更好的关于质量的总结信息。这项研究的具体目的如下： 1)使用几个候选模型来评估风险调整后的质量护理指标的潜在维度，包括：1)过程/结果域；2)质量指标(QL)内容域；3)MDS QL的医疗/护理起源。 2)根据疗养院在具体目标1中创建的维度的功能，创建疗养院的分类。 3)通过比较疗养院的结构/组织方面的集群来评估和测试这一分类。 这项研究的数据来自一个项目，该项目调查了养老院护理工作量和护理质量之间的关系。2003年所有明尼苏达州疗养院的MDS记录将被检查。统计方法包括验证性因素分析、两阶段聚类分析、马诺瓦和回归。

DESCRIPTION (provided by the applicant): Minimum Data Set (MDS) nursing home quality indicators (QIs) have been used for a variety of purposes by a variety of audiences. Yet, despite prolonged and intense examination, the concept of how to use quality indicators to draw conclusions about nursing homes is still in its infancy. Researchers tend to use a large number of measures without focusing on how they work together and offering little comment on how they can be used to compare one facility to another. This project aims to address some of these deficiencies by creating a classification of nursing homes based on their performance along dimensions of quality. This research could aid current efforts to link nursing home reimbursement to quality incentives, and to provide better summary information on quality to consumers. The specific aims of this study are as follows: 1) To evaluate the underlying dimensions of risk adjusted quality care indicators using several model candidates including: 1) process/outcome domains 2) Quality Indicator (Ql) content domains and 3) medical/nursing origin of the MDS Qls. 2) To create a categorization of nursing homes based on their functioning on the dimensions created in Specific Aim 1. 3) To evaluate and test this categorization by comparing the clusters with regard to the structural/organizational aspects of the nursing homes. The data for this study come from a project which examines the relationship between the amount of nursing effort and quality of care achieved in a nursing home. MDS records for all Minnesota nursing homes in 2003 will be examined. Statistical approaches include confirmatory factor analysis, two stage cluster analysis, MANOVA and regression.