Variations in risk-adjusted outcomes in a managed acute/long-term care program for frail elderly individuals

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
Dana B MukamelT Franklin Williams

Abstract

To develop and investigate the properties of three performance measures based on risk-adjusted health outcomes for a frail, elderly, community-dwelling population enrolled in a managed, acute, and long-term care program. Retrospective analyses of an administrative dataset containing individual level records with information about socioeconomics, health, functional and cognitive status, diagnoses, and treatments. We estimated risk-adjustment models predicting mortality, decline in functional status, and decline in self-assessed health. Each model includes individual risk factors and indicator variables for the program site in which the individual enrolled. Sites were ranked based on their performance in each risk-adjusted outcome, and the properties of these performance measures were investigated. Twenty-eight sites of the Program of All-Inclusive Care for the Elderly (PACE) that provide primary, acute, and long-term care services under capitated Medicare and Medicaid payment to a nursing home certifiable, and functionally and cognitively frail community-dwelling elderly population. Three thousand one hundred and thirty-eight individuals who were newly enrolled between 1 January 1998 and 31 December 1999. The average age of thes...Continue Reading

Citations

May 8, 2010·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Li-Fan Liu, Miin-Jye Wen
Aug 12, 2008·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Helena Temkin-GreenerDana B Mukamel
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Sep 15, 2021·Palliative Medicine·Alex HallBarbara Hanratty

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