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https://doi.org/10.21256/zhaw-22577| Publication type: | Article in scientific journal |
| Type of review: | Peer review (publication) |
| Title: | Adjusting client-level risks impacts on home care organization ranking |
| Authors: | Wagner, Aylin Schaffert, René Dratva, Julia |
| et. al: | No |
| DOI: | 10.3390/ijerph18115502 10.21256/zhaw-22577 |
| Published in: | International Journal of Environmental Research and Public Health |
| Volume(Issue): | 18 |
| Issue: | 11 |
| Page(s): | 5502 |
| Issue Date: | 21-May-2021 |
| Publisher / Ed. Institution: | MDPI |
| ISSN: | 1660-4601 1661-7827 |
| Language: | English |
| Subjects: | Spitex; Risikoadjustierung; Qualitätsmessung; Qualitätsindikator |
| Subject (DDC): | 362: Health and social services |
| Abstract: | Quality indicators (QIs) based on the Resident Assessment Instrument-Home Care (RAI-HC) offer the opportunity to assess home care quality and compare home care organizations’ (HCOs) performance. For fair comparisons, providers’ QI rates must be risk-adjusted to control for different case-mix. The study’s objectives were to develop a risk adjustment model for worsening or onset of urinary incontinence (UI), measured with the RAI-HC QI bladder incontinence, using the database HomeCareData and to assess the impact of risk adjustment on quality rankings of HCOs. Risk factors of UI were identified in the scientific literature, and multivariable logistic regression was used to develop the risk adjustment model. The observed and risk-adjusted QI rates were calculated on organization level, uncertainty addressed by nonparametric bootstrapping. The differences between observed and risk-adjusted QI rates were graphically assessed with a Bland-Altman plot and the impact of risk adjustment examined by HCOs tertile ranking changes. 12,652 clients from 76 Swiss HCOs aged 18 years and older receiving home care between 1 January 2017, and 31 December 2018, were included. Eight risk factors were significantly associated with worsening or onset of UI: older age, female sex, obesity, impairment in cognition, impairment in hygiene, impairment in bathing, unsteady gait, and hospitalization. The adjustment model showed fair discrimination power and had a considerable effect on tertile ranking: 14 (20%) of 70 HCOs shifted to another tertile after risk adjustment. The study showed the importance of risk adjustment for fair comparisons of the quality of UI care between HCOs in Switzerland. |
| URI: | https://digitalcollection.zhaw.ch/handle/11475/22577 |
| Fulltext version: | Published version |
| License (according to publishing contract): | CC BY 4.0: Attribution 4.0 International |
| Departement: | School of Health Sciences |
| Organisational Unit: | Institute of Public Health (IPH) |
| Published as part of the ZHAW project: | Swiss Home Care Data: Bessere Daten zur Qualität der häuslichen Pflege (Spitex) |
| Appears in collections: | Publikationen Gesundheit |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 2021_Wagner-Schaffert-Dratva_Adjusting-client-level-risks-impacts.pdf | 1.57 MB | Adobe PDF |  View/Open |
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Wagner, A., Schaffert, R., & Dratva, J. (2021). Adjusting client-level risks impacts on home care organization ranking. International Journal of Environmental Research and Public Health, 18(11), 5502. https://doi.org/10.3390/ijerph18115502
Wagner, A., Schaffert, R. and Dratva, J. (2021) ‘Adjusting client-level risks impacts on home care organization ranking’, International Journal of Environmental Research and Public Health, 18(11), p. 5502. Available at: https://doi.org/10.3390/ijerph18115502.
A. Wagner, R. Schaffert, and J. Dratva, “Adjusting client-level risks impacts on home care organization ranking,” International Journal of Environmental Research and Public Health, vol. 18, no. 11, p. 5502, May 2021, doi: 10.3390/ijerph18115502.
WAGNER, Aylin, René SCHAFFERT und Julia DRATVA, 2021. Adjusting client-level risks impacts on home care organization ranking. International Journal of Environmental Research and Public Health. 21 Mai 2021. Bd. 18, Nr. 11, S. 5502. DOI 10.3390/ijerph18115502
Wagner, Aylin, René Schaffert, and Julia Dratva. 2021. “Adjusting Client-Level Risks Impacts on Home Care Organization Ranking.” International Journal of Environmental Research and Public Health 18 (11): 5502. https://doi.org/10.3390/ijerph18115502.
Wagner, Aylin, et al. “Adjusting Client-Level Risks Impacts on Home Care Organization Ranking.” International Journal of Environmental Research and Public Health, vol. 18, no. 11, May 2021, p. 5502, https://doi.org/10.3390/ijerph18115502.
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