Journals of Gerontology Series A: Biological Sciences and Medical Sciences Large Type Edition
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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 60:323 (2005)
© 2005 The Gerontological Society of America

LETTER TO THE EDITOR

STABILITY AND SENSITIVITY OF NURSING HOME QUALITY INDICATORS

Bruce E. Robinson, MD, MPH

Sarasota Memorial Hospital University of South Florida Sarasota, Florida

Address correspondence to Bruce E. Robinson, MD, MPH, Sarasota Memorial Hospital, 1700 S. Tamiami Tr., Sarasota, FL 34239. E-mail: bruce-robinson{at}smh.com

To the Editor:

Included in Dr. Rantz' work is a credible and reasonable job in creating a rating system using Minimum Data Set data that divide homes into good, fair, and poor performers. She provides detailed data on the stability of these ratings across a 5-month period. Further analysis of this repeated measurement shows a Kappa measurement of agreement of 0.26.

This lack of reasonable stability of nursing home ratings over even short periods of time leads me to conclude that it is entirely wrong to provide these ratings to consumers (who never heard of a Kappa) with the idea that the rating they read will reflect the care they can expect to receive in a nursing home. Either the Minimum Data Set "outcomes" are a poor measure of care, which as a clinician I can believe, or nursing homes are so rapidly changing from good to bad that publishing ratings is futile.

Reference

  1. Rantz MJ, Hicks L, Petroski GF, et al. Stability and sensitivity of nursing home quality indicators [Rapid Communication]. J Gerontol Med Sci. 2004;59A:79-82.




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