Improving quality report cards through inclusion of consumers preferences

通过纳入消费者偏好来提高报告卡质量

• 批准号: 9103796
• 负责人: DANA B MUKAMEL
• 金额: $ 65.02万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9103796
• 关键词: Address; Admission activity; Affordable Care Act; Characteristics; Charge; Clinical; Congresses; Consumer Preferences; Data; Data Analyses; Data Collection; Decubitus ulcer; Dependence; Development; Dimensions; Economics; Effectiveness; Elasticity; Equilibrium; Failure; Family; Family member; Federal Government; Future; Government; Health; Health Status; Healthcare; Healthcare Market; Home environment; Hospitals; Incentives; Individual; Insurance; Lead; Marketing; Measures; Methodology; Modification; Nature; Nursing Homes; Patient-Centered Care; Patients; Price; Process; Provider; Publishing; Quality of Care; Recommendation; Reporting; Respondent; Sampling; Surveys; System; Techniques; Testing; Weight; base; cost; design; experience; falls; hedonic; improved; information gathering; mental state; preference; prospective; public health relevance; response; socioeconomics; statistics; success

 DESCRIPTION (provided by applicant): Quality report cards are intended to inform consumers, increase the demand elasticity for quality, enhance competition and as a result lead to quality improvement. Evidence to-date suggests that some report cards, such as the CMS Nursing Home Compare (NHC), may fall short on reaching these objectives because of the complexity of the information they provide. NHC includes information about staffing, deficiency citation and 18 Quality Measures (QMs). This large amount of information presents a challenge to consumers when choosing a nursing home. Individuals have been shown in prior studies to be able to make better choices when they have summary measures that integrate the multiple dimensions of quality and simplify their decision process. Recognizing this need, and in response to a request from Congress, CMS introduced the "5 Star" system in 2008. It offers summary measures along 4 dimensions: 1) an overall rating; 2) ratings based on QMs; 3) ratings based on staffing; 4) ratings based on deficiencies. The relative weights of each component in the summary measures reflect the preferences and recommendations made by an expert panel convened by CMS. This proposal is motivated by the recognition that an expert panel may not be representative of the "average" nursing home resident or family members, who are the actual decision makers. Therefore, the objective of this proposal is to elicit preferences of individuals with recent nursing home admission experience and use those preferences to develop and test alternative, consumer-driven, "5 Star" systems. To achieve this objective a survey will be administered to a large national sample of respondents with recent nursing home admission experience. The survey will elicit preferences with respect to nursing home quality, utilizing hedonic pricing and contingent valuation techniques. It will also gather information about socio-demographic, economic and health status to allow tests of hypotheses regarding the dependence of preferences on these factors. This information, in conjunction with quality measures calculated from the MDS and OSCAR files, will be used to develop two alternative composite ranking systems. The rankings based on hedonic pricing and contingent valuations would be compared to each other and to the "5 Star", expert panel based rankings. This project will offer information that could guide future improvements to the "5 Star" system, as called for by the Patient Protection and Affordable Care Act of 2010 (ACA). Furthermore, it is responsive to the priorities included in the "National Strategy for Quality Improvement in Health Care," which emphasizes patient and family preferences as guiding patient centered care.

 描述（由适用提供）：质量成绩单旨在告知消费者，增加质量的需求弹性，增强竞争并因此导致质量提高。待命的证据表明，由于它们提供的信息的复杂性，某些报告卡（例如CMS疗养院比较（NHC））可能会达到这些目标。 NHC包括有关人员配备，缺陷引用和18种质量措施（QMS）的信息。在选择护士家时，大量信息给消费者带来了挑战。在先前的研究中已经证明了个体可以在整合质量多个维度并简化其决策过程的摘要测量时能够做出更好的选择。认识到这一需求，并应对国会的要求，CMS在2008年引入了“ 5星”系统。它提供了沿4个维度的摘要测量：1）总体评级； 2）基于QM的评分； 3）基于人员的评分； 4）基于缺陷的评分。摘要测量中每个组件的相对权重反映了CMS召集的专家小组提出的偏好和建议。该提案的激励是因为人们认识到专家小组可能无法代表“普通”护士家庭居民或家庭成员，即实际的决策者。因此，该提案的目的是引起具有近期疗养院入学经验的个人的偏好，并利用这些偏好来开发和测试替代，消费者驱动的“ 5星”系统。为了实现这一目标，将向一个大量的全国性样本进行调查，负责最近的疗养院入学经验。该调查将利用享乐定价和偶然的价值技术来引起对护士家庭质量的偏好。还收集有关社会人口统计学，经济和健康状况的信息，以允许对偏好对这些因素的依赖性进行假设的测试。该信息以及根据MDS和Oscar文件计算出的质量度量，将用于开发两个替代的综合排名系统。基于享乐定价和偶然值的排名将相互比较，并将基于专家小组的“ 5星”排名进行比较。项目将提供可以指导“ 5星”系统未来改进的信息，因为 由2010年的《患者保护和负担得起的护理法》（ACA）要求。此外，它对“国家医疗保健质量改善质量改进战略”的优先级有回应，该命令强调患者和家庭偏好是指导患者以患者为中心的护理。