Nursing Homes Response to Quality Indictors Publication

疗养院对质量指标发布的反应

基本信息

批准号：
7409988
负责人：
DANA B MUKAMEL
金额：
$ 25.1万
依托单位：
UNIVERSITY OF CALIFORNIA-IRVINE
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-05-01 至 2011-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7409988
关键词：
Accounting Administrator Admission activity Adopted Adoption Advertising Affect Behavior Caring Case Mixes Client Clinical Complex Congresses Cream Data Data Analyses Data Set Deterioration Dimensions Discipline of Nursing Educational process of instructing Enrollment Environment Environmental Risk Factor Expenditure Funding Goals Health Care Costs Health Planning Home Nursing Care Hospitals Incentives Information Systems Institute of Medicine (U.S.)Knowledge Lead Location Measures Medical Medicare Monitor Nursing Homes Outcome Ownership Patients Personnel Management Physicians Policies Practice Guidelines Principal Investigator Process Protocols documentation Provider Publications Publishing Quality Indicator Quality of Care Recommendation Regression Analysis Regulation Relative (related person)Reporting Resource Allocation Resources Rewards Score Skilled Nursing Facilities Surveys System Techniques Testing United States Centers for Medicare and Medicaid Services Urinary Incontinence Work base cost design experience health care service organization improved insight instrument programs response

项目摘要

DESCRIPTION (provided by applicant): Quality of care in many of the nation's nursing homes has been long recognized as inadequate despite efforts to reform and strengthen regulations. A more recent CMS policy initiative designed to improve quality relies on publication of nursing home quality report cards, which allow patients to easily compare relative quality ranking of competing nursing homes. Publication of such report cards is expected to provide nursing facilities with positive incentives to improve the quality of care they offer. Report cards may, however, also lead nursing homes to adopt "dysfunctional" strategies, such as "cream skimming" or "teaching to the test". Such strategies may adversely affect quality and access to nursing home care. The empirical evidence about the response of health care organizations in general, and nursing homes in particular, to such report cards is scant and inconclusive. In the proposed study we will examine the response of nursing homes to the publication of the CMS quality report cards and will answer two questions: 1) What factors determine which strategies nursing homes adopt in response to quality reports? And 2) what is the impact of such strategies on quality? The proposed study will compare data from the period prior to publication of the report to data from a period following publication to examine changes in behavior of nursing homes. We will create a comprehensive data set with information about: 1) the strategies that nursing homes adopted following publication and their views of the quality report cards (based on a national survey of nursing homes), 2) quality before and after publication of the reports measured along different dimensions, including those published in the reports, others that are not published, and hotel quality (based on MDS data merged with Medicare enrollment data and data on resource use obtained from nursing home cost reports) and 3) information about changes in admission profiles (MDS data). Statistical regression techniques will be used to analyze the data and test specific hypotheses.

描述（由申请人提供）：尽管努力改革和加强法规，但长期以来，美国许多疗养院的护理质量一直被认为是不足的。最近一项旨在提高质量的 CMS 政策举措依赖于发布疗养院质量报告卡，该报告卡使患者能够轻松比较竞争疗养院的相对质量排名。此类成绩单的发布预计将为护理机构提供积极的激励，以提高其提供的护理质量。然而，成绩单也可能导致疗养院采取“功能失调”的策略，例如“撇脂”或“应试教学”。此类策略可能会对疗养院护理的质量和可及性产生不利影响。关于医疗保健组织，特别是疗养院对此类报告卡的反应的经验证据很少且不确定。在拟议的研究中，我们将检查疗养院对 CMS 质量报告卡发布的反应，并回答两个问题：1）哪些因素决定疗养院针对质量报告采取哪些策略？ 2）此类策略对质量有何影响？拟议的研究将比较报告发布前一段时间的数据与报告发布后一段时间的数据，以检查疗养院行为的变化。我们将创建一个全面的数据集，其中包含以下信息：1）疗养院在发布后采取的策略以及他们对质量报告卡的看法（基于对疗养院的全国调查），2）报告发布前后的质量从不同维度进行衡量，包括报告中公布的、其他未公布的以及酒店质量（基于与医疗保险登记数据合并的 MDS 数据以及从疗养院成本报告中获得的资源使用数据）以及 3）有关变化的信息入学资料（MDS 数据）。统计回归技术将用于分析数据并测试特定假设。