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. 2022 Mar 29:3:830175.
doi: 10.3389/fresc.2022.830175. eCollection 2022.

Risk Adjustment in Home and Community Based Services Outcome Measurement

James Houseworth  1 , Tina Kilaberia  2 , Renata Ticha  1 , Brian Abery  1
Affiliations

Risk Adjustment in Home and Community Based Services Outcome Measurement

James Houseworth et al. Front Rehabil Sci. .

Abstract

The purpose of this study was to review and evaluate existing research that used risk adjusters in disability research. Risk adjustment controls for individual characteristics of persons when examining outcomes. We have conducted a systematic review and an evaluation of existing studies that included risk adjusters for outcomes of people with disabilities receiving services (home or community based). The process included coding each study according to the type(s) of risk adjusters employed and their relation to the specific population and outcomes within a framework. Panels were utilized to prioritize the risk adjusters. Findings indicate that four risk adjusters can be tentatively recommended as potential candidate risk adjusters: chronic conditions, functional disability, mental health status, and cognitive functioning. Holistic Health and Functioning far outweighed other outcomes studied to date. Further, there is a need for testing recommended risk adjusters across multiple outcomes and different populations of people with disabilities.

Keywords: National Quality Forum; disability; home and community based services; outcome measurement; risk adjuster.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Representation of risk adjusted models.
Figure 2
Figure 2
Flow diagram of literature search and selection process.
See this image and copyright information in PMC

References

    1. Shaughnessy PW, Hittle DF. Overview of Risk Adjustment and Outcome Measures for Home Health Agency OBQI Reports: Highlights of Current Approaches Outline of Planned Enhancements. Denver, CO: Center for Health Services Research, UCHSC; (2002). Available online at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Inst... (accessed July 29, 2021).
    1. Gressel JW. Development of a quality ranking model for home health care providers. Health Market Q. (2013) 30:246–62. 10.1080/07359683.2013.814503 - DOI - PubMed
    1. Iezzoni LI. Risk adjustment for performance measurement. In: Performance Measurement for Health System Improvement: Experiences, Challenges and Prospects. Cambridge University Press (2009). p. 251.
    1. Jencks SF. Changing health care practices in Medicare's Health Care Quality Improvement Program. Jt Comm J Qual Improv. (1995) 21:343–47. 10.1016/S1070-3241(16)30160-2 - DOI - PubMed
    1. Iezzoni LI. editor. Risk Adjustment for Measuring Health Care Outcomes (Vol. 3). Chicago, IL: Health Administration Press; (2003).

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