A study of reliability and burden of home health assessment using OASIS.
The Outcome and Assessment Information Set (OASIS) is used for outcome reporting, quality improvement, and case mix adjustment of per-episode payment for home health care. The research described here addresses interrater reliability of OASIS items and compares clinician time required to complete patient assessment with and without OASIS. Interrater reliability for OASIS data items was estimated using independent assessments by two clinicians for a sample of 66 patients. Incremental assessment time due to OASIS was estimated using interview data from two agency-matched groups of clinical care providers--one group who used OASIS in the assessment and a second group whose assessment did not include OASIS items. Interrater reliability is excellent (kappa > .80) for many OASIS items and substantial (kappa > 0.60) for most items. The reported time required to complete an assessment with OASIS did not differ from the time required for a comparable assessment without OASIS. The results of this study are being used to guide developmental efforts to improve OASIS items. They can also be informative to home health care agencies when interpreting OASIS-based outcome and case mix reports.
Hittle
David F
DF
Center for Health Services Research (CHSR), University of Colorado Health Sciences Center, Denver CO 80222, USA. David.Hittle@UCHSC.edu
Shaughnessy
Peter W
PW
Crisler
Kathryn S
KS
Powell
Martha C
MC
Richard
Angela A
AA
Conway
Karin S
KS
Stearns
Paula M
PM
Engle
Karen
K
D003625:Data Collection; D003953:Diagnosis-Related Groups; D006699:Home Care Services / Q000592:standards*; D006278:Medicare; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D011445:Prospective Payment System; D017749:Total Quality Management