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Examining MDS resident assessments for the impact on public policy |
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In this exploratory study, Minimum Data Set (MDS) resident assessment data was used to describe and compare changes in resident status before and after OBRA implementation on October 1, 1990. Data for this study were extracted for two states from the Multi-State Nursing Home Case-Mix and Quality Demonstration Project. Simple linear regression was used to predict post-OBRA resident status scores based on two pre-OBRA measurements. These were predictions of what changes in resident status scores might have been likely if the legislation had never been initiated. Actual resident status scores post-OBRA were compared with the predicted values. It appears an unintended consequence of the legislative initiative was an adverse impact on
activities of daily living (ADL) function in the six month period post-OBRA implementation. ADL's for these residents declined significantly post-OBRA beyond the predicted levels. Additionally, the use of physical restraints was actually higher post-OBRA than the predicted values. It appears there was a significant reduction in the use of physical restraints in the
months prior to OBRA implementation. However, the reduction did not continue at its pre-OBRA level of decline. The use of resident assessment information is recommended when undertaking evaluation of public policy initiatives.
Rantz, M.J. (1995). Examining MDS resident assessments for the impact on public policy. Journal of Long-Term Care Administration, 23(3), 18-21. |