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（由申请人提供）：质量报告卡旨在告知消费者，增加质量需求弹性，增强竞争，从而提高质量。迄今为止的证据表明，一些报告卡，例如 CMS 疗养院。 Compare (NHC) 可能无法实现这些目标，因为 NHC 提供的信息非常复杂，其中包括有关人员配置、缺陷引用和 18 项质量措施 (QM) 的信息。这些大量信息给消费者选择带来了挑战。先前的研究表明，当人们认识到这一需求并响应国会的要求时，他们能够做出更好的选择，综合考虑质量的多个维度并简化他们的决策过程。 2008年推出了“5星”系统，它提供了4个维度的汇总衡量标准：1）总体评级；2）基于质量管理的评级；3）基于人员配置的评级；4）基于相对权重的评级。摘要措施中的每个组成部分反映了 CMS 召集的专家小组提出的偏好和建议。该提案的动机是认识到专家小组可能无法代表“普通”疗养院居民或家庭成员。因此，本提案的目的是引出最近有入住疗养院经历的个人的偏好，并利用这些偏好来开发和测试替代的、消费者驱动的“5 星级”系统，以实现这一目标。将针对最近居住在疗养院的大量全国受访者样本进行该调查将利用享乐定价和条件估值技术来得出对疗养院质量的偏好，还将收集有关社会人口、经济和健康状况的信息，以便检验有关偏好对这些因素的依赖性的假设。该信息与根据 MDS 和 OSCAR 文件计算的质量衡量标准一起，将用于开发两个基于特征定价和或有估值的替代综合排名系统，并与“5 星”进行比较。 ，基于专家小组该项目将提供可以指导“五星级”系统未来改进的信息，例如 此外，它还响应了《2010 年患者保护和平价医疗法案》(ACA) 中包含的优先事项，该战略强调患者和家庭的偏好，以指导以患者为中心的护理。