期刊
HEALTH SERVICES RESEARCH
卷 44, 期 2, 页码 379-398出版社
WILEY-BLACKWELL PUBLISHING, INC
DOI: 10.1111/j.1475-6773.2008.00915.x
关键词
Quality of care; postacute care; nursing home quality; public reporting
资金
- Agency for Healthcare Research and Quality [R01 HS016478-01]
- University Research Foundation of the University of Pennsylvania
- VA HSR&D Career Development Award
- Pennsylvania Department of Health
The impact of quality improvement incentives on nontargeted care is unknown and some have expressed concern that such incentives may be harmful to nontargeted areas of care. Our objective is to examine the effect of publicly reporting quality information on unreported quality of care. The nursing home Minimum Data Set from 1999 to 2005 on all postacute care admissions. We studied 13,683 skilled nursing facilities and examined how unreported aspects of clinical care changed in response to changes in reported care after public reporting was initiated by the Centers for Medicare and Medicaid Services on their website, Nursing Home Compare, in 2002. We find that overall both unreported and reported care improved following the launch of public reporting. Improvements in unreported care were particularly large among facilities with high scores or that significantly improved on reported measures, whereas low-scoring facilities experienced no change or worsening of their unreported quality of care. Public reporting in the setting of postacute care had mixed effects on areas without public reporting, improving in high-ranking facilities, but worsening in low-ranking facilities. While the benefits of public reporting may extend beyond areas that are being directly measured, these initiatives may also widen the gap between high- and low-quality facilities.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据