title: Case mix adjustment in nursing systems research: the case of resident outcomes in nursing homes.
abstract: Case mix indicates, for a resident population, the degree of risk for developing favorable or unfavorable outcomes. In a study of 164 nursing homes, we explored two methods for combining resident assessment data into a case mix index (CMI). We compared a facility-level, composite CMI to a prevalence-based CMI comprised of 22 separate resident characteristics for their adequacy in explaining resident outcomes. The prevalence-based CMI consistently explained more variance in outcomes than the facility level, composite CMI. This study indicates a reasonable method for using administrative databases containing resident assessment data to adjust for the influence of case mix on nursing home resident outcomes.
authors.affiliation: Duke University School of Nursing, DUMC 3322, Durham, NC 27710, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Anderson
authors.forename: H F
authors.initials: HF
authors.lastname: Su
authors.forename: P C
authors.initials: PC
authors.lastname: Hsieh
authors.forename: C A
authors.initials: CA
authors.lastname: Allred
authors.forename: S
authors.initials: S
authors.lastname: Owensby
authors.forename: G
authors.initials: G
authors.lastname: Joiner-Rogers
mesh_terms: D050723:Fractures, Bone; D006801:Humans; D001523:Mental Disorders; D015401:Nursing Administration Research / Q000379:methods*; D009732:Nursing Care / Q000592:standards*; D009735:Nursing Homes / Q000592:standards* / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D019984:Quality Indicators, Health Care; D020379:Risk Adjustment / Q000458:organization & administration; D012307:Risk Factors; D013781:Texas