You may view this newsletter online at http://www.ohiokepro.com/newsletters/hh/V000173-01152007/ Home Health Tip of the Week
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QIO HHQI Weekly Update :: January 15th, 2007

TIP OF THE WEEK

Using the CASPER case mix analysis reports

As you may have heard, a new CASPER report was made available to home health agencies (HHAs) in December 2006. The “Case Mix Analysis Summary Report” is designed to provide a summary of the differences in the case mix factors among patients that achieved a particular outcome, compared with those patients that did not achieve each outcome.

Comparing any differences in case mix values between these two groups of patients may help you to identify risk factors that are applicable in the HHA. Early identification and classification of these risk factors supports the Process of Care Investigation phase of the Outcome Based Quality Improvement (OBQI) process, and could enable you to be more proactive in establishing interventions that will improve the outcome rates for the HHA.

FREQUENTLY ASKED QUESTIONS

  1. What does the Case Mix Analysis Report show? This report shows the differences in case mix values between two groups: home health episodes that achieved an outcome versus those that did not.
  2. What data period is represented in the Case Mix Analysis Report? The data period reflected in the report is noted at the top of the report (under the agency name). In addition, the number of episodes that achieved the outcome is also given.
  3. Why do some numbers have percent signs and some do not? Some case mix values are reported as a percentage of the population and some are reported as an average. Values measured by the presence or absence of a case mix factor have a percent sign (e.g., female gender, Medicaid as a payment source, etc.). Values that do not have a percent sign are averages (e.g., age); many are from OASIS items that are measured using a scale (e.g., bathing is measured on a scale from 0 to 5).
  4. What does it mean if the difference is positive? When the difference is positive (i.e., greater than zero), then the case mix value is higher among patients that achieved an outcome.
  5. What does it mean if the difference is negative? When the difference is negative (i.e., less than zero), then the case mix value is higher among the patients that did not achieve an outcome.
  6. Why don’t the percentages add up to 100% (across the rows)? They are not supposed to. The percentages are calculated from within each group separately (achieved vs. not achieved).
  7. Why don’t the percentages in a given section add up to 100% (in a column)? Many of the case mix values are based on OASIS items for which multiple items can be marked (e.g., Assisting persons, based on M0350). The sum for groups of case mix values such as these will likely be greater than 100%.
    Furthermore, there are not always case mix values for all the available choices for a particular OASIS item (e.g., Residence, based on M0300). The sum for groups of case mix values such as these will likely be less than 100%.
  8. When should a difference be interpreted as meaningful? This depends on the magnitude of the difference in relation to the scale of the measure (for example, the scale for percentages is 0 to 100; for bathing, the scale is 0 to 5). The difference should also represent a clinically meaningful difference. It may be helpful to start by analyzing the largest differences for your agency, and then systematically determining if the difference is clinically relevant for your agency’s patient population.
  9. Why do some of the case mix measures have a shaded background? The case mix measures with the green background shading are those that are associated with risk factors for hospitalization that have been reported in the scientific literature. These measures may or may not be risk factors for your particular patient population.

RESOURCE SPOTLIGHT

ACH Event Tree
The acute care hospitalization (ACH) event tree represents the pathways that may lead to a hospitalization of a home health patient. The event tree illustrates the complexity of hospitalization among home health patients. It also helps staff to focus on the "big picture," which helps them recognize and understand the many different causes behind ACH. Once staff is able to understand the causes, they are more successful in identifying the strategies that will reduce the need for hospitalization among your patients.

 

IN THE NEWS

YOUNG PEOPLE OFTEN SERVE AS CAREGIVERS FOR PARENTS WITH DISABILITIES, CHRONIC ILLNESSES BECAUSE OF COSTS ASSOCIATED WITH IN-HOME HEALTH CARE

January 5, 2007 - - Kaiser Network - - A 2005 study funded by the U.S. Administration on Aging and conducted by the National Alliance for Caregiving and the United Hospital Fund Foundation found that as many as 1.3 million to 1.4 million children in the U.S. ages eight to 18 provide care for a family member with a chronic illness or disability, and more than 400,000 child caregivers are younger than age 12. Read more >>

 

 

COMING ATTRACTIONS

KICK-OFF TO THE OHIO HOME HEALTH COMMUNITY OF PRACTICE

January 18, 2007, 9:00-10:00 a.m. or 3:00-4:00 p.m.

INDUSTRY EVENTS

Teleconference: Ohio Immunization Partners for Healthy Adults, January 18, 2007 1:00-2:00 p.m. Please call Liz Simpson at 1-800-385-5080 for more information.


The Tip of the Week Archive is available on the Ohio KePRO Web Site.