Improving nursing home quality of care through outcomes data: the MDS quality indicators.
BACKGROUND
The quality of care provided to nursing home residents is a continuing source of concern throughout the world. In the United States, the Health Care Financing Administration mandated the use of a standardised resident assessment instrument, called the Minimum Data Set (MDS) which facilitated the development of a set of nursing home quality of care indicators.


METHODS
The MDS Quality Indicators were developed by a team of researchers at the University of Wisconsin-Madison and covered 12 domains, as well as associated risk factors. This initial set of indicators then went through an iterative process of review by national clinical panels, further empirical analysis, validation studies, and pilot tests, to confirm whether they were accurate, reliable and useful tools for identifying quality problems.


RESULTS
The final set of MDS Quality Indicators includes 24 variables that include both processes and outcomes of care and prevalence and incidence measures. They are defined at both the resident and facility level. Four of the indicators are risk-adjusted.


CONCLUSIONS
The indicators have several possible applications: a source of consumer information; to help guide policy makers; and to assist providers in conducting quality improvement initiatives and to evaluate the impact of these efforts.
Zimmerman
David R
DR
Center for Health Systems Research and Analysis, University of Wisconsin-Madison, Madison, WI 53709, USA.
D006801:Humans; D009735:Nursing Homes / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000379:methods; D011787:Quality of Health Care / Q000592:standards*; D015203:Reproducibility of Results; D012307:Risk Factors; D014481:United States