Table 4.
The Association between Hospice Concentration and the Occurrence of Disagreement in Pain Rating on Nonhospice Residents between NH and Study Nurses: Mild Daily or Worse Pain versus No Pain or Mild Less than Daily Pain (Cutoff=1)
| False Positive (FP) | False Negative (FN) | |
|---|---|---|
| Null models with random intercepts | ||
| Unexplained variance at facility level | ||
| Variance | 0.60 (0.13)* | 0.47 (0.12) |
| Covariance | −0.09 (0.09) | |
| Intraclass correlation | 0.10 | 0.06 |
| Full models with random intercepts | ||
| Hospice concentration (%) | ||
| 0−3 | —† | — |
| 3−5 | 0.62 (0.37–1.04) | 0.72 (0.44–1.20) |
| 5+ | 0.60 (0.37–0.97) | 0.82 (0.54–1.27) |
| Age (centered) | ||
| Linear term | 1.05 (0.88–1.25) | 1.30 (1.10–1.54) |
| Quadratic term | 0.96 (0.88–1.05) | 1.05 (0.96–1.14) |
| Cognitive impairment | ||
| No or mild (CPS=0 or 1) | — | — |
| Moderate (CPS=2 or 3) | 0.64 (0.47–0.86) | 0.81 (0.59–1.12) |
| Severe (CPS=4, 5, or 6) | 0.46 (0.30–0.69) | 1.04 (0.71–1.51) |
| Having cancer | 0.99 (0.66–1.49) | 1.24 (0.82–1.88) |
| Having dementia | 1.14 (0.80–1.61) | 0.94 (0.68–1.32) |
| Male | 0.87 (0.66–1.14) | 1.06 (0.80–1.40) |
| Nurse hours/resident | 0.89 (0.74–1.08) | 0.95 (0.80–1.14) |
| Occupancy rate <80% | 1.57 (1.08–2.30) | 0.94 (0.64–1.38) |
| Part of a chain | 0.77 (0.56–1.06) | 1.09 (0.80–1.49) |
| Having 100+beds | 1.13 (0.76–1.67) | 1.01 (0.69–1.46) |
| Number of health deficiencies >50th percentile in the state | 1.06 (0.74–1.51) | 1.02 (0.73–1.44) |
| Location of the study nursing home | ||
| California | 1.71 (0.95–3.09) | 0.73 (0.39–1.35) |
| Illinois | 1.11 (0.61–2.02) | 1.76 (1.04–2.97) |
| Missouri | 1.48 (0.71–3.07) | 3.05 (1.66–5.60) |
| Ohio | 2.72 (1.52–4.87) | 0.95 (0.51–1.75) |
| Pennsylvania | 1.40 (0.80–2.46) | 1.12 (0.67–1.88) |
| Tennessee | — | — |
| Unexplained variance at facility level | ||
| Variance | 0.36 (0.11) | 0.25 (0.10) |
| Covariance | 0.01 (0.08) | |
*
Standard error of variance at the level of nursing home.
†
Referent group.