Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-22577
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dc.contributor.authorWagner, Aylin-
dc.contributor.authorSchaffert, René-
dc.contributor.authorDratva, Julia-
dc.date.accessioned2021-06-03T13:16:07Z-
dc.date.available2021-06-03T13:16:07Z-
dc.date.issued2021-05-21-
dc.identifier.issn1660-4601de_CH
dc.identifier.issn1661-7827de_CH
dc.identifier.urihttps://digitalcollection.zhaw.ch/handle/11475/22577-
dc.description.abstractQuality indicators (QIs) based on the Resident Assessment Instrument-Home Care (RAI-HC) offer the opportunity to assess home care quality and compare home care organizations’ (HCOs) performance. For fair comparisons, providers’ QI rates must be risk-adjusted to control for different case-mix. The study’s objectives were to develop a risk adjustment model for worsening or onset of urinary incontinence (UI), measured with the RAI-HC QI bladder incontinence, using the database HomeCareData and to assess the impact of risk adjustment on quality rankings of HCOs. Risk factors of UI were identified in the scientific literature, and multivariable logistic regression was used to develop the risk adjustment model. The observed and risk-adjusted QI rates were calculated on organization level, uncertainty addressed by nonparametric bootstrapping. The differences between observed and risk-adjusted QI rates were graphically assessed with a Bland-Altman plot and the impact of risk adjustment examined by HCOs tertile ranking changes. 12,652 clients from 76 Swiss HCOs aged 18 years and older receiving home care between 1 January 2017, and 31 December 2018, were included. Eight risk factors were significantly associated with worsening or onset of UI: older age, female sex, obesity, impairment in cognition, impairment in hygiene, impairment in bathing, unsteady gait, and hospitalization. The adjustment model showed fair discrimination power and had a considerable effect on tertile ranking: 14 (20%) of 70 HCOs shifted to another tertile after risk adjustment. The study showed the importance of risk adjustment for fair comparisons of the quality of UI care between HCOs in Switzerland.de_CH
dc.language.isoende_CH
dc.publisherMDPIde_CH
dc.relation.ispartofInternational Journal of Environmental Research and Public Healthde_CH
dc.rightshttp://creativecommons.org/licenses/by/4.0/de_CH
dc.subjectSpitexde_CH
dc.subjectRisikoadjustierungde_CH
dc.subjectQualitätsmessungde_CH
dc.subjectQualitätsindikatorde_CH
dc.subject.ddc362: Gesundheits- und Sozialdienstede_CH
dc.titleAdjusting client-level risks impacts on home care organization rankingde_CH
dc.typeBeitrag in wissenschaftlicher Zeitschriftde_CH
dcterms.typeTextde_CH
zhaw.departementGesundheitde_CH
zhaw.organisationalunitInstitut für Public Health (IPH)de_CH
dc.identifier.doi10.3390/ijerph18115502de_CH
dc.identifier.doi10.21256/zhaw-22577-
zhaw.funding.euNode_CH
zhaw.issue11de_CH
zhaw.originated.zhawYesde_CH
zhaw.pages.start5502de_CH
zhaw.publication.statuspublishedVersionde_CH
zhaw.volume18de_CH
zhaw.publication.reviewPeer review (Publikation)de_CH
zhaw.funding.snf167499de_CH
zhaw.webfeedG: Arbeit und Gesundheitde_CH
zhaw.funding.zhawSwiss Home Care Data: Bessere Daten zur Qualität der häuslichen Pflege (Spitex)de_CH
zhaw.author.additionalNode_CH
zhaw.display.portraitYesde_CH
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Wagner, A., Schaffert, R., & Dratva, J. (2021). Adjusting client-level risks impacts on home care organization ranking. International Journal of Environmental Research and Public Health, 18(11), 5502. https://doi.org/10.3390/ijerph18115502
Wagner, A., Schaffert, R. and Dratva, J. (2021) ‘Adjusting client-level risks impacts on home care organization ranking’, International Journal of Environmental Research and Public Health, 18(11), p. 5502. Available at: https://doi.org/10.3390/ijerph18115502.
A. Wagner, R. Schaffert, and J. Dratva, “Adjusting client-level risks impacts on home care organization ranking,” International Journal of Environmental Research and Public Health, vol. 18, no. 11, p. 5502, May 2021, doi: 10.3390/ijerph18115502.
WAGNER, Aylin, René SCHAFFERT und Julia DRATVA, 2021. Adjusting client-level risks impacts on home care organization ranking. International Journal of Environmental Research and Public Health. 21 Mai 2021. Bd. 18, Nr. 11, S. 5502. DOI 10.3390/ijerph18115502
Wagner, Aylin, René Schaffert, and Julia Dratva. 2021. “Adjusting Client-Level Risks Impacts on Home Care Organization Ranking.” International Journal of Environmental Research and Public Health 18 (11): 5502. https://doi.org/10.3390/ijerph18115502.
Wagner, Aylin, et al. “Adjusting Client-Level Risks Impacts on Home Care Organization Ranking.” International Journal of Environmental Research and Public Health, vol. 18, no. 11, May 2021, p. 5502, https://doi.org/10.3390/ijerph18115502.


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