However, the quality of service indicator in this case is a specific functional health condition rather than an adverse event in and of itself. Thus, a patient who has a higher quality of service (for instance, has better quality of ambulation or longer duration of stay) has lower OBI-score scores. A health-status improvement on a case-management-level score does not necessarily translate into a patient who is discharged home with better functional and/or health status. However, the point at which the OBI score improves represents a step-up in care quality. Q2. What constitutes 'impaired' in a particular health status outcome on an OBI report? A2. IMPAIRMENT is calculated based on the respective OASIS scale. Impaired is assessed as a health status event where the scale value for one outcome parameter indicates less impairment than the scale value for the other outcome parameter, irrespective of whether the values are the same or not. Q3. How is a difference in the OBI score and the quality of service indicator calculated and expressed on each individual OBI report? For instance, if I am a health-status patient and the score in one parameter is 3, but the quality of service indicator is 3.3, and you have three separate OBI reports — one for me, one for my partner and one for my partner's partner, can you tell me the difference between the three OBI reports? A3. Yes. The OBI (quality of care) data are reported using standard OASIS metrics. For instance, the OBI score for a baseline visit (or the date of admission/discharge) is 3.0, while the outcome value used for the subsequent day's care is 3.03. The OBI score for the next day and the day following is 3.03 minus 3.0. The OBI score for the following day has a quality-of-care improvement of 1 point, while the one for the following day has a quality-of-care improvement of 0.1. Q4. Where to draw the line between the OBI score and the quality of service indicator?
A4. As with any OBI report, it's up to you to make each case-management decision based on your knowledge and experience and your judgment. However, once an individual patient is discharged home, the final decision is made by the patient's primary care doctor, nurse and the HSE. Q5.
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CATEGORY 11 OBI REPORTS Q1. What constitutes 'improved' in a particular health status outcome on an OBI report? A1. An improvement in any particular health status outcome is calculated from the respective
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