Assessing the feasibility of linking Section G and Section GG measures of function in skilled nursing facilities.

Background and Objectives In skilled nursing facilities (SNFs), Section GG replaced Section G as the instrument for measuring function in 2023. To inform how previously validated scales and scores derived from Section G items might be re-produced from Section GG items, we examined key measurement as...

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Publicado en:Gerontologist Vol. 66; no. 7; pp. 1 - 12
Autores principales: Lam, Kenneth, White, Elizabeth M, McConeghy, Kevin W, Scherer, Laura D, Stevens-Lapsley, Jennifer, Mor, Vincent, Smyth, Heather L, Gutman, Roee
Formato: Artículo
Publicado: Oxford University Press / USA Jul2026
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Acceso en línea:Ver este registro en EBSCOhost
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          Lam, Kenneth
          White, Elizabeth M
          McConeghy, Kevin W
          Scherer, Laura D
          Stevens-Lapsley, Jennifer
          Mor, Vincent
          Smyth, Heather L
          Gutman, Roee
        affil:
          Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
          Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, United States
          Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, United StatesTransformative Health Systems Research to Improve Veteran Equity and Independence Center of Innovation (THRIVE COIN), Veterans Affairs Providence Health Care System, Providence, Rhode Island, United States
          Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United StatesVA Seattle-Denver Center of Innovation, Aurora, Colorado, United States
          Geriatric Research Education and Clinical Center (GRECC), Eastern Colorado VA Health Care System, Aurora, Colorado, United StatesDepartment of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
          Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, United States
          Department of Biostatistics, Brown University, Providence, Rhode Island, United States
      su:
        United States
        Cross-sectional method
        Rehabilitation
        Nursing care facilities
        Psychometrics
        Activities of daily living
        Statistical models
        Statistical correlation
        Database management
        Data analysis
        Research funding
        Functional status
        Research methodology
        Research
        Statistics
        Health outcome assessment
        Comparative studies
        Factor analysis
      sug:
        subj:
          Cross-sectional method
          Rehabilitation
          Nursing care facilities
          Psychometrics
          Activities of daily living
          United States
          Data Processing, Hosting, and Related Services
          Nursing Care Facilities (Skilled Nursing Facilities)
          Community care facilities for the elderly
          Statistical models
          Statistical correlation
          Database management
          Data analysis
          Research funding
          Functional status
          Research methodology
          Research
          Statistics
          Health outcome assessment
          Comparative studies
          Factor analysis
      keyword:
        activities of daily living
        copyrightHolder:The Gerontological Society of America
        copyrightYear:2026
        Functional measurement
        functional measures
        https://dx.doi.org/10.1093/geront/gnag116
        inLanguage:en
        long-term care
        Minimum Data Set
        Nursing home
        nursing homes
        publisher:Oxford University Press
        rehabilitation
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42172600/
        skilled nursing facility
        tissue approximation
        weight measurement scales
        activities of daily living
        copyrightHolder:The Gerontological Society of America
        copyrightYear:2026
        Functional measurement
        functional measures
        https://dx.doi.org/10.1093/geront/gnag116
        inLanguage:en
        long-term care
        Minimum Data Set
        Nursing home
        nursing homes
        publisher:Oxford University Press
        rehabilitation
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42172600/
        skilled nursing facility
        tissue approximation
        weight measurement scales
      ab: Background and Objectives In skilled nursing facilities (SNFs), Section GG replaced Section G as the instrument for measuring function in 2023. To inform how previously validated scales and scores derived from Section G items might be re-produced from Section GG items, we examined key measurement assumptions in both instruments. Research Design and Methods We identified 1,131,694 Minimum Data Set 3.0 assessments of unique persons with complete Sections GG and G between October 2018 and September 2023 across 2,200 SNFs in the Long-Term Care Data Cooperative. We examined: (i) assessment instructions, (ii) item-level Spearman's correlations, (iii) measures of fit and factor structure in confirmatory and exploratory factor analyses, and (iv) graded response item response theory parameters. Results Several Section GG items were conceptually similar and highly correlated (ρ  ≥ 0.7). After removing redundant items, a combined scale of both instruments was not unidimensional in confirmatory factor analyses (Comparative Fit Index = 0.753, Tucker-Lewis Index = 0.724, root-mean-square error of approximation = 0.153) and items from each instrument generally loaded onto separate but correlated factors (inter-factor correlation 0.735) in exploratory factor analyses. In item response theory analyses, Section GG items better captured independence while Section G items better captured dependence. Discussion and Implications Sections GG and G measure related yet distinct constructs, emphasizing the need for caution when interpreting a sum of Section GG items as a reflection of underlying health in SNF patients. Scales and scores derived from Section G items cannot be presumed to be equivalent when derived from Section GG items, and further work is needed examining interchangeability.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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