Strategic orientation and nursing home response to public reporting of quality measures: an application of the miles and snow typology.
Strategic orientation and nursing home response to public reporting of quality measures: an application of the miles and snow typology.
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战略定位和疗养院对质量措施公开报告的响应：里程和雪类型学的应用。
DOI：
10.1111/j.1475-6773.2007.00781.x
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发表时间：
2008
影响因子：
3.4
通讯作者：
Mukamel,DanaB
中科院分区：
文献类型：
--
作者：
Zinn,JacquelineS;Spector,WilliamD;Weimer,DavidL;Mukamel,DanaB
目的：评估Miles和Snow类型学所确定的养老院战略定位的差异是否与他们对养老院比较网站上公布的质量测量结果的反应差异有关。数据来源：全国10%随机抽样的管理员调查在2004年5月至6月进行的第一次发表的《疗养院比较报告》中包括的所有设施中，有1 502家疗养院;研究设计：因变量是二分的，表明是否采取行动和采取行动的类型。为四种战略类型中的每一种创建了四个指标变量：防御者，分析者，勘探者和反应者。其他变量包括在七个逻辑回归模型中，以控制策略类型以外的因素，这些因素可能会影响养老院对公开披露其护理质量的反应。数据收集/提取方法：调查数据与第一份报告中的质量测量和组织特征数据合并（2002年11月）。主要调查结果：大约43%的被调查管理员自认为是捍卫者，其次是分析者（33%）和探索者（19%）。自我选择最少的战略类型是反应堆（6.6%）。一般来说，回归模型的结果表明，不同策略类型的管理员对质量指标发布的反应存在差异，与捍卫者相比，探索者和分析者更有可能做出反应，而反应者则不太可能做出反应。结论虽然近三分之一的管理员根本没有采取任何行动，但我们的结果表明，无论何时，以及疗养院对联邦报告的质量措施的反应与战略方向有关。
Objective.To assess whether differences in strategic orientation of nursing homes as identified by the Miles and Snow typology are associated with differences in their response to the publication of quality measures on the Nursing Home Compare website.Data Sources.Administrator survey of a national 10 percent random sample (1,502 nursing homes) of all facilities included in the first publication of the Nursing Home Compare report conducted in May–June 2004; 724 responded, yielding a response rate of 48.2 percent.Study Design.The dependent variables are dichotomous, indicating whether or not action was taken and the type of action taken. Four indicator variables were created for each of the four strategic types: Defender, Analyzer, Prospector, and Reactor. Other variables were included in the seven logistic regression models to control for factors other than strategic type that could influence nursing home response to public disclosure of their quality of care.Data Collection/Extraction Methods.Survey data were merged with data on quality measures and organizational characteristics from the first report (November 2002).Principal Findings.About 43 percent of surveyed administrators self‐typed as Defenders, followed by Analyzers (33 percent), and Prospectors (19 percent). The least self‐selected strategic type was the Reactor (6.6 percent). In general, results of the regression models indicate differences in response to quality measure publication by strategic type, with Prospectors and Analyzers more likely, and Reactors less likely, to respond than Defenders.Conclusions.While almost a third of administrators took no action at all, our results indicate that whether, when, and how nursing homes reacted to publication of federally reported quality measures is associated with strategic orientation.