Table 4.
Recommended covariates and examination of factors associated with risk adjustment
| QI Short Title | Recommended Covariate | Unadjusted QI Rate | Effect of covariate on QI Trigger rate | Covariate adjusted QI trigger rate (%) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall n/D (%) | Covariate present n/D (%) | Covariate absent n/D (%) | Odds Ratio (95 CI) | p-value | Range across sites | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | ||
| Bladder Catheter | C1: Incontinent Premorbid; Female | 42/340 (12%) | 11/64 (17%) | 31/276 (11%) | 1.6 (0.8, 3.5) | .21 | 3—21 | 7 | 3 | 20 | 17 | 21 | 16 | 9 | 9 | 7 |
| Cognition | C1: Resident of long-term care | 68/608 (11%) | 19/77 (25%) | 49/530 (9%) | 3.2 (1.8, 5.8) | < .001 | 2—22 | 11 | 2 | 11 | 10 | 9 | 17 | 22 | 9 | 8 |
| C2: Impaired premorbid cognitive function | 3/20 (15%) | 65/588 (11%) | 1.4 (0.4, 5.0) | .48 | 1—22 | 11 | 1 | 12 | 10 | 8 | 18 | 22 | 10 | 9 | ||
| C3: Surgery a part of acute episode | 0/12 (0%) | 67/587 (11%) | n/a | .38 | 2—22 | 11 | 2 | 12 | 10 | 8 | 18 | 22 | 10 | 9 | ||
| Mobility | C1: Fall within last 90 days | 207/596 (35%) | 109/233 (47%) | 98/363 (27%) | 2.4 (1.7, 3.4) | < .0001 | 20—52 | 52 | 20 | 40 | 38 | 27 | 36 | 31 | 41 | 27 |
| C2: Existing or new RACF living arrangements | 41/84 (49%) | 166/512 (32%) | 2.0 (1.2, 3.2) | < .01 | 18—49 | 49 | 18 | 40 | 39 | 30 | 36 | 32 | 41 | 28 | ||
| C3: Discharge to rehabilitation | 37/50 (74%) | 170/546 (31%) | 6.3 (3.3, 12.1) | < .0001 | 18—52 | 52 | 18 | 42 | 43 | 31 | 34 | 29 | 40 | 25 | ||
| Skin Integrity | C1: Poor Bed mobility premorbid | 10/617 (2%) | 4/48 (8%) | 6/569 (1%) | 8.5 (2.3, 31.4) | < .01 | 0—4 | 4 | 2 | 4 | 1 | 0 | 0 | 2 | 0 | 1 |
| C2: Nutritional issues | 1/105 (1%) | 9/505 (2%) | 0.5 (0.1, 4.2) | 1 | 0—4 | 4 | 1 | 4 | 1 | 0 | 0 | 1 | 0 | 1 | ||
| C3: Prior pressure injury | 2/42 (5%) | 8/569 (1%) | 3.5 (0.7, 17.1) | .15 | 0—4 | 4 | 1 | 4 | 1 | 0 | 0 | 2 | 0 | 2 | ||
| Falls | C1: Low premorbid cognitive function | 37/643 (6%) | 3/25 (12%) | 34/611 (6%) | 2.3 (0.7, 8.1) | .17 | 1—9 | 4 | 3 | 8 | 8 | 6 | 1 | 9 | 5 | 8 |
| C2: Fall within 90 days | 20/249 (8%) | 17/394 (4%) | 1.9 (1.0, 3.8) | .056 | 1—8 | 4 | 3 | 8 | 8 | 5 | 1 | 8 | 5 | 8 | ||
| Prolonged Length of Stay | C1: Discharged to rehabilitation | 62/643 (10%) | 9/51 (18%) | 53/592 (9%) | 2.2 (1.0, 4.7) | .078 | 1—21 | 11 | 7 | 13 | 21 | 10 | 4 | 1 | 2 | 16 |
| New Discharge to Residential Care | C1: Low premorbid cognitive function | 28/451 (6%) | 3/7 (43%) | 25/440 (6%) | 12.4 (2.6, 58.7) | < .01 | 2—14 | 9 | 3 | 14 | 7 | 5 | 2 | 4 | 5 | 4 |
| C2: Prior admission to hospital in the last 90 days | 14/183 (8%) | 14/268 (5%) | 1.5 (0.7, 3.2) | .32 | 2—16 | 9 | 3 | 16 | 7 | 5 | 2 | 4 | 5 | 5 | ||
| C3: Premorbid problems with hygiene | 10/56 (18%) | 18/395 (5%) | 4.6 (2.0, 10.5) | < .001 | 2—14 | 7 | 3 | 14 | 7 | 5 | 2 | 4 | 6 | 5 | ||
| C4: Premorbid inability to manage finances | 22/174 (13%) | 6/277 (2%) | 6.5 (2.6, 16.5) | < .0001 | 3—16 | 8 | 4 | 16 | 7 | 4 | 3 | 3 | 7 | 4 | ||
Care assessment and planning targeting all patients at all times have no covariate recommendations: Delirium, Self-Care, and Pain. QI quality indicator
*Statistically significant (p < 0.05)