Profiling nursing homes using Bayesian hierarchical modeling.
J Am Geriatr Soc
; 50(6): 1126-30, 2002 Jun.
Article
en En
| MEDLINE
| ID: mdl-12110077
ABSTRACT
OBJECTIVES:
New methods developed to improve the statistical basis of provider profiling may be particularly applicable to nursing homes. We examine the use of Bayesian hierarchical modeling in profiling nursing homes on their rate of pressure ulcer development.DESIGN:
Observational study using Minimum Data Set data from 1997 and 1998.SETTING:
A for-profit nursing home chain.PARTICIPANTS:
Residents of 108 nursing homes who were without a pressure ulcer on an index assessment. MEASUREMENTS Nursing homes were compared on their performance on risk-adjusted rates of pressure ulcer development calculated using standard statistical techniques and Bayesian hierarchical modeling.RESULTS:
Bayesian estimates of nursing home performance differed considerably from rates calculated using standard statistical techniques. The range of risk-adjusted rates among nursing homes was 0% to 14.3% using standard methods and 1.0% to 4.8% using Bayesian analysis. Fifteen nursing homes were designated as outliers based on their z scores, and two were outliers using Bayesian modeling. Only one nursing home had greater than a 50% probability of having a true rate of ulcer development exceeding 4%.CONCLUSIONS:
Bayesian hierarchical modeling can be successfully applied to the problem of profiling nursing homes. Results obtained from Bayesian modeling are different from those obtained using standard statistical techniques. The continued evaluation and application of this new methodology in nursing homes may ensure that consumers and providers have the most accurate information regarding performance.
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Banco de datos:
MEDLINE
Asunto principal:
Indicadores de Calidad de la Atención de Salud
/
Hogares para Ancianos
/
Casas de Salud
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
J Am Geriatr Soc
Año:
2002
Tipo del documento:
Article
País de afiliación:
Estados Unidos