Assessment Reliability

"Reliability of a Structured Assessment for Nonclinicians to Detect Delirium Among New Admissions to Postacute Care." Samuel E. Simon, Margaret A. Bergman, Richard N. Jones, Katherine M. Murphy, E. John Orav, and Edward R. Marcantonio. Journal of the American Medical Directors Association, September 2006. Researchers evaluated the interrater reliability of a structured delirium assessment method for nonclinician interviews with elderly patients newly admitted to postacute care. The structured delirium assessment process produced very high interobserver agreement. Nonclinician interviewers using a structured assessment achieved reliability that rivaled or exceeded that of trained clinical assessors in other studies. The authors note that nonclinicians may offer an effective alternative for the assessment of delirium among postacute patients in skilled nursing facilities.

Nursing Home Quality

"The Effect of Urinary Incontinence on Quality of Life in Older Nursing Home Residents." Catherine E. DuBeau, Samuel E. Simon, and John N. Morris. Journal of the American Geriatrics Society, September 2006. Researchers sought to determine whether nursing home residents with urinary incontinence have worse quality of life than continent residents, whether the relationship between continence and quality of life differs across strata of cognitive and functional impairment, and whether change in continence status is associated with change in quality of life. This is the first study to demonstrate quantitatively that prevalent and new or worsening incontinence decreases quality of life even in frail functionally and cognitively impaired nursing home residents. These results provide a crucial incentive to improve continence care and quality in nursing homes and a rationale for targeting interventions to those residents most likely to benefit.

Children's Well-Being

Improving the well-being of young children and their families is an ongoing national concern. Our newly updated Early Childhood web pages reflect the scope and diversity of our work in this area, which includes evaluating many facets of the Head Start and Early Head Start programs, examining the role of low-income fathers, assessing school readiness, and studying the quality of child care in multiple settings.

Occupational Decisionmaking

"Enduring Links: Parents' Expectations and Their Young Adult Children's Gender-Typed Occupational Choices." Janis E. Jacobs, Christina S. Chhin, and Martha M. Bleeker. Educational Research and Evaluation, August 2006. This study examined (1) the relation between parents' gender-typed occupational expectations for their children at age 15 and their children's own reports of occupational expectations at age 17; (2) the long-term relations between parents' gender-typed occupational expectations for their children at age 17 and their children's actual occupation at age 28; and (3) the relation between job satisfaction and having a gender-traditional or nontraditional job. The results indicate that parents' gender-typed occupational expectations were significantly related to children's own expectations and to their actual career choices, and job satisfaction was significantly related to having a gender-typed career. The findings suggest that parents' early gender-typed expectations for their children's occupational achievements were highly related to the actual occupational decisions made by the adult children.

Pay for Performance

“Health Plan Pay-for-Performance Strategies.” Sally Trude, Melanie Au, and Jon B. Christianson. American Journal of Managed Care, September 2006. This article examines health plan strategies, planning development, and implementation of pay-for-performance programs (financial incentives for hospitals and physicians tied to quality and efficiency) at the community level, focusing on differences across the 12 Community Tracking Study site visit areas. Most health plans are committed to pay-for-performance programs. Although providers would prefer health plans in their communities to use a single standardized set of measures and methods, this is unlikely given local market environments. A national effort directed at standardization might significantly reduce the extent of customization but also may limit the opportunities for local collaboration with providers.

Hospital Quality Reporting

"The Impact of Quality-Reporting Programs on Hospital Operations." Hoangmai H. Pham, Jennifer Coughlan, and Ann S. O’Malley. Health Affairs, 2006. This article uses data from the 2005-2006 Community Tracking Study site visits to examine the impact of quality reporting on hospitals’ data collection and review processes, feedback and accountability mechanisms, quality improvement activities, and resource allocation. Individual hospitals participate in multiple, varied reporting programs with distinct effects on hospital operations. Reporting programs play complementary roles in encouraging quality improvement but are poorly coordinated and command sizable resources, in large part because of inadequate information technology. Policy should be directed at encouraging formal assessments of how individual and combinations of programs affect quality outcomes, and the development of adaptable information systems.

Read more about the Community Tracking Study.

IT Outsourcing Support

With the federal government's move toward increasingly complicated computerized operations, the need for more sophisticated information technology (IT) systems increases. Often, this need is best addressed through outsourcing to private-sector IT vendors. This in turn fuels the need for highly specialized vendor oversight and monitoring support to ensure the government's IT outsourcing needs are met as efficiently and cost-effectively as possible. A new web page details the full suite of information technology outsourcing support services we provide to help government agencies fulfill their mission-critical IT outsourcing needs. Our experience ranges from requirements definition and procurement support through testing, auditing, on-site monitoring, security assessments, and program management support. Please contact outsourcing@mathematica-mpr.com if you have questions about our capabilities.

On the Move: Staff News and Changes

Mathematica recently announced the appointment of Paul Decker as president of the company effective January 1, 2007. Decker, currently executive vice president and chief operating officer, is a nationally recognized expert in education and workforce development policy. He will succeed Charles E. Metcalf, who has been president and CEO of Mathematica since 1986 and had been director of research from 1975 to 1986. Read more.