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Reducing Random Variation in Reported Rates of Pressure Ulcer Development

Bibliographic Data

ID9101759
AuthorsDan R Berlowitz (0000-0002-8783-5611, Bedford VA Research Corporation, corresponding author), Jennifer J Anderson (Bedford VA Research Corporation), Arlene S Ash (0000-0002-8448-0253, Bedford VA Research Corporation), Gary H Brandeis (0000-0003-3348-0496, Bedford VA Research Corporation), Harriet K Brand (Bedford VA Research Corporation), Mark A Moskowitz (Bedford VA Research Corporation)
Year1998
Volume36
Issue6
Pages818-825
Publication date1998-06-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199806000-00005
PMID9630123
OpenAlexW2052643668
LanguageEN
Citations received2
References cited17

OBJECTIVES: The authors evaluated methods of reporting on rates of pressure ulcer development in long-term care to identify approaches that lead to more stable estimates of actual performance. METHODS: Performance measures for facilities that adequately adjust for both random variation and casemix should be relatively stable from one time period to the next. The authors calculated facility rates of pressure ulcer development over eight consecutive time periods and correlated measures over time using different reporting methods including z-scores, combining rates from several time periods, and limiting analyses to large facilities. Results were compared with a Monte Carlo simulation. RESULTS: Observed facility rates of pressure ulcer development varied considerably over time. The average correlation coefficient across seven time comparisons for observed rates was 0.17. Reporting performance as a z-score or limiting the analyses to large facilities increased the correlation. Combining two time periods was effective only when used with one of these other approaches. The correlation coefficient based on a simulation using only large facilities was 0.51. CONCLUSIONS: Random variation affects reported rates of pressure ulcer development. Using only large facilities and combining two time periods limits the effects of random variation and results in more stable estimates of performance. When describing performance, management must consider tradeoffs between having more accurate data, the frequency with which data are provided, and whether it is given to all providers

Correlation · Correlation coefficient · Econometrics · Limiting · Monte Carlo method · Random effects model · Statistics · Variation (astronomy) · Computer Science · Engineering · Health Policy Implementation Science · Healthcare Operations and Scheduling Optimization · Internal Medicine · Mathematics · Medicine · Pressure Ulcer Prevention and Management

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Citations per year0.1
Citation span2005 - 2013 (9)
Highly citedNo

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