What Is Nursing Home Quality and How Is It Measured?
What Is Nursing Home Quality and How Is It Measured?
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DOI：
10.1093/geront/gnq052
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发表时间：
2010-08-01
期刊：
影响因子：
5.7
通讯作者：
Ferguson, Jamie C.
中科院分区：
文献类型：
--
作者：
Castle, Nicholas G.;Ferguson, Jamie C.
目的：在这篇评论中，我们检查养老院的质量和指标，已被用来衡量养老院的质量。设计和方法：简要回顾了疗养院质量的历史，提供了一些背景和洞察目前使用的质量指标。Donabedian的结构、过程和结果（SPO）模型用于框架讨论。讨论了当前的质量指标和质量举措，包括设施质量指标概况报告、养老院比较、医疗保险/医疗补助认证中包含的缺陷引用和推进卓越运动。结果：当前的质量指标呈现为结构、过程和结果测量的混合，每一个都有明显的优点和缺点。我们推测未来需要采取哪些措施来解决和潜在地提高养老院提供的护理质量，包括成绩单、绩效薪酬、基于市场的激励措施以及认证过程中的政策发展。在整个综述中确定了未来研究的领域。启示：我们的结论是，养老院的质量可能有所改善，但仍需改进。
Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO) model is used to frame the discussion. Current quality indicators and quality initiatives are discussed, including those included in the Facility Quality Indicator Profile Report, Nursing Home Compare, deficiency citations included as part of Medicare/Medicaid certification, and the Advancing Excellence Campaign. Results: Current quality indicators are presented as a mix of structural, process, and outcome measures, each of which has noted advantages and disadvantages. We speculate on steps that need to be taken in the future to address and potentially improve the quality of care provided by nursing homes, including report cards, pay for performance, market-based incentives, and policy developments in the certification process. Areas for future research are identified throughout the review. Implications: We conclude that improvements in nursing home quality have likely occurred, but improvements are still needed.