Assessment of level of care: implications of interrater reliability on health policy.
Gustafson, David H
Date of Pub
Koningsveld, Richard V; Peterson, Robert W
In Wisconsin, level-of-care assessments are used to set Medicaid reimbursement and determine nursing home eligibility. This
study examined three methods of assessing level of care: 1) the Wisconsin quality assurance project (QAP) method, based on
observations of patients, patient records, and staff interviews; 2) the Wisconsin standard (STD) method, based primarily on
a clinical record review; and, 3) an adaptation of New York's "DMS-I," a checklist with numerical weights used to set level
of care. Results address interrater reliability, the agreement between assessments by research teams and actual levels of
care set by the State, and the implications that agreement has for reimbursement.
Costs and Cost Analysis : Diagnosis-Related Groups : Insurance, Health, Reimbursement : Nursing Homes/economics : Patient
Care Planning/methods : Statistics : Support, U.S. Gov't, Non-P.H.S. : Wisconsin