Factors influencing nursing home response to quality measure publication: A resource dependence perspective.
Factors influencing nursing home response to quality measure publication: A resource dependence perspective.
复制标题
影响疗养院对质量衡量标准发布的反应的因素：资源依赖的角度。
DOI：
10.1097/hmr.0b013e3181e23d64
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发表时间：
2010
影响因子：
2.5
通讯作者：
Mukamel,DanaB
中科院分区：
文献类型：
--
作者：
Zinn,JacquelineS;Weimer,DavidL;Spector,William;Mukamel,DanaB
背景：医疗保险和医疗补助服务中心在一个名为Nursing Home Compare（NHC）的网站上提供了疗养院的报告卡，其中包括有关19项临床质量指标（QM）的信息。该信息的目的是告知消费者的选择，提供一个重点，为国家监管举措，并促进疗养院的质量改进efforts.Purpose：本研究旨在确定哪些因素与疗养院的投资质量出版后的NHC report card.Methodology：2007年的调查发送到全国各地的疗养院管理人员询问他们的反应出版的QM NHC。调查数据与来自NHC的QM和组织特征数据合并。因变量代表需要在人员配置和/或设备方面投入大量资源的行动。独立变量测试假设的影响，构成群体，竞争和管理式医疗参与投资。我们估计logistic回归模型调整集群内states.Findings：养老院认为，报告卡影响关键选区（专业转介来源，消费者和国家调查员）的程度与承诺大量资源，以提高报告卡性能的几率。在竞争性市场中，报告的QM分数较低的设施进行某些投资的可能性是高质量设施的三倍。感知QM的有效性和密切监测的分数也激励investment.Practice影响：相当大比例的养老院现在认为，报告卡影响专业转介，消费者的选择，和国家调查的解释过程。这表明，QM出版物可能确实具有竞争力的影响，因为它涉及这些选区，从而增加了提高分数的风险，并使大量投资更有可能。
Background:The Centers for Medicare and Medicaid Services provides a report card on nursing homes at a Web site called Nursing Home Compare (NHC) that includes information on 19 clinical quality measures (QMs). The information is intended to inform consumer choice, to provide a focus for state regulatory initiatives, and to promote nursing home quality improvement efforts.Purpose:This study aimed to determine what factors were associated with nursing homes' investment in quality after publication of the NHC report card.Methodology:A 2007 survey sent to nursing home administrators nationally inquired about their response to publication of QMs on NHC. Survey data were merged with data on QMs and organizational characteristics from NHC. The dependent variables represent actions requiring a significant investment of resources in staffing and/or equipment. Independent variables tested hypotheses regarding the influence of constituent groups, competition, and managed care participation on investment. We estimated logistic regression models adjusting for clustering within states.Findings:The degree to which nursing homes perceive that the report card influences key constituencies (professional referral sources, consumers, and state surveyors) is associated with the odds of committing substantial resources to improve report card performance. Facilities with lower reported QM scores were three times more likely to make certain investments than high-quality facilities in competitive markets. Perceived QM validity and close monitoring of scores also motivates investment.Practice Implications:A substantial proportion of nursing homes now perceive that the report card influences professional referrals, consumer choice, and state survey investigatory process. This suggests that QM publication may indeed have a competitive impact as it concerns these constituencies, thus increasing the stakes in improving the scores and making substantial investments much more likely.