Wysocki Andrea, Thomas Kali S, Mor Vincent
Mathematica Policy Research, Washington, DC.
School of Public Health, Brown University, Providence RI; Providence VA Medical Center, Providence, RI.
J Am Med Dir Assoc. 2015 Jun 1;16(6):470-4. doi: 10.1016/j.jamda.2014.11.018. Epub 2015 Feb 3.
To examine the completeness of the activities of daily living (ADL) items on admission and discharge assessments and the improvement in ADL performance among short-stay residents in the newly adopted Minimum Data Set (MDS) 3.0.
Retrospective analysis of MDS admission and discharge assessments.
Nursing homes from July 1, 2011, to June 30, 2012.
New nursing home residents admitted from acute hospitals with corresponding admission and discharge assessments between July 1, 2011, and June 30, 2012, who had a length of stay of 100 days or less.
ADL self-performance items, including bed mobility, transfer, walking in room, walking in corridor, locomotion on unit, locomotion off unit, dressing, eating, toilet use, and personal hygiene, at admission and discharge.
The ADL self-performance items are complete at both admission and discharge, with less than 1% missing for any item. More than 60% of residents improved over the course of their post-acute stay. New short-stay nursing home residents with conditions such as cognitive impairment, delirium, dementia, heart failure, and stroke showed less improvement in ADL performance during their stay.
The discharge assessment data in the MDS 3.0 provide new information to researchers and providers to examine and track ADL performance. Nursing homes can identify and track patients who require more intensive therapies or targeted interventions to achieve functional improvement during their stay. Future research can examine facility-level measures to better understand how ADL improvement varies across facilities.
检查新采用的最小数据集（MDS）3.0中入住和出院评估时日常生活活动（ADL）项目的完整性，以及短期居住居民ADL表现的改善情况。
对MDS入住和出院评估进行回顾性分析。
2011年7月1日至2012年6月30日期间的养老院。
2011年7月1日至2012年6月30日期间从急性医院收治的有相应入住和出院评估的新养老院居民，住院时间为100天或更短。
入住和出院时的ADL自我表现项目，包括床上活动、转移、室内行走、走廊行走、单元内活动、单元外活动、穿衣、进食、使用厕所和个人卫生。
ADL自我表现项目在入住和出院时均完整，任何项目的缺失率均低于1%。超过60%的居民在急性后期住院期间有所改善。患有认知障碍、谵妄、痴呆、心力衰竭和中风等疾病的新短期居住养老院居民在住院期间ADL表现改善较少。
MDS 3.0中的出院评估数据为研究人员和提供者提供了新信息，以检查和跟踪ADL表现。养老院可以识别和跟踪那些在住院期间需要更强化治疗或有针对性干预以实现功能改善的患者。未来的研究可以检查机构层面的措施，以更好地了解不同机构间ADL改善情况的差异。
