A Comprehensive Clinical Assessment Tool to Inform Policy and Practice

The Minimum Data Set (MDS) for nursing home (NH) resident assessment, designed to assess elders functional status and care needs, exemplifies how the information needs of clinical practice are congruent with those of research. Building on a review of the published literature, this article describes the development of the MDS, its reliability and validity testing, as well as the variety of different policy and research uses to which it has been applied. Interrater reliability of items and internal consistency of MDS summary scales is generally good to excellent. Validation studies reveal good correspondence to research quality instruments for cognition, activities of daily living, and diagnoses with more variable results for vision, pain, mood, and behavior scales. To date, no consistent evidence suggests that applications of MDS data for case-mix reimbursement and quality indicator monitoring systematically bias the data. Although facility variation in data quality could compromise some applications, creation of the MDS as a clinical tool for care planning provides an example of how assessment tools with clinical use can be used in administrative databases for research and policy applications

Consistency (knowledge bases) · Data quality · Health care · Inter-rater reliability · Minimum Data Set · Nursing homes · Operations management · Quality (philosophy) · Rating scale · Reimbursement · Reliability (semiconductor) · Variety (cybernetics) · Applied Psychology · Computer Science · Dementia and Cognitive Impairment Research · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medicine · Nursing · Psychology

• Instrumentos desenvolvidos para o gerenciamento e cuidado de idosos em instituições de longa permanência

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• Racial Disparities in Rehospitalization Among Medicare Patients in Skilled Nursing Facilities

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• The Health Consequences of Using Physical Restraints in Nursing Homes

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• Reliability Estimates of Clinical Measures Between Minimum Data Set and Online Survey Certification and Reporting Data of US Nursing Homes

  Ning Jackie Zhang, Seung Chun Paek et al.•Medical Care•2009

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• Use of Antipsychotics Among Older Residents in VA Nursing Homes

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• Nursing Home Admissions Among Medicaid HCBS Enrollees

  Xueya Cai, Helena Temkin‐greener et al.•Medical Care•2015

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• Measuring the Quality of Care Provided to Community Dwelling Vulnerable Elders Dually Enrolled in Medicare and Medicaid

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• Driven to Tiers

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• Race, Education, and the Treatment of Depression in Nursing Homes

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• Nursing Working Conditions in Relation to Restraint Practices in Long-Term Care Units

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• Assessing Medication Exposures and Outcomes in the Frail Elderly

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• Measuring the Quality of Care Provided to Dually Enrolled Medicare and Medicaid Beneficiaries Living in Nursing Homes

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• Outcomes Research

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• Identifying Appropriate Reference Data Models for Comparative Effectiveness Research (CER) Studies Based on Data from Clinical Information Systems

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• MDS Cognitive Performance Scale(C)

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• Scaling ADLs Within the MDS

  John N Morris, Brant E Fries et al.•The Journals of Gerontology…•1999

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• Resource Utilization Groups

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• Influence of Facility Characteristics on Use of Antipsychotic Medications in Nursing Homes

  Carmel Hughes, Carmel M Hughes et al.•Medical Care•2000

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• Facility Characteristics Associated With Hospitalization of Nursing Home Residents

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• Studies of Process-Outcome Correlations in Medical Care Evaluations

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• Refining a Case-Mix Measure for Nursing Homes

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• Validity of Diagnostic and Drug Data in Standardized Nursing Home Resident Assessments

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