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To examine geographic and facility variation in cognitive and motor functional outcomes after postacute inpatient rehabilitation in patients with stroke.
However, we did observe substantial facility variation in QI reliability.
Future research examining the completeness of these records relative to Medicare claims and enrollment files will hopefully reveal greater correspondence and completeness with relatively little inter-state or facility variation.
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The relatively positive findings on the overall performance of the QI's belies considerable inter-facility variation.
All participants identified considerable between-facility variation in the types of data collected and data collection formats used.
While we did observe some inter-facility variation in selected diagnoses, most facilities had high correspondence between hospital and MDS diagnoses.
The between-facility variation revealed that most facilities had reasonable reliability for most QIs, while some facilities had unacceptably low kappa scores for several QIs.
In light of the substantial inter-facility variation in QI reliability, we sought to identify facility characteristics that might be related to data reliability.
The power calculation assumes a 14% crude referral proportion in the control group based on baseline referral data and an intra-cluster correlation coefficient (ICC) of 0.01 to 0.05, respectively, to account for between-facility variation.
Indeed, the quality of the MDS data has been shown to have considerable inter-facility variation, even amongst facilities that volunteered for a study of their quality of MDS assessment[ 15].
On the other hand, our finding of considerable inter-facility variation in measurement may suggest that the selection of the facility for participation is influential in determining the results.
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