Effects of the CMS' Public Reporting Program for Inpatient Psychiatric Facilities on Targeted and Nontargeted Safety: Differences Between For-Profits and Nonprofits.
Effects of the CMS' Public Reporting Program for Inpatient Psychiatric Facilities on Targeted and Nontargeted Safety: Differences Between For-Profits and Nonprofits.
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CMS的住院精神病学设施公共报告计划对有针对性和非目标安全性的影响：营利性和非营利组织之间的差异。
DOI：
10.1177/1077558721998924
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Shields MC
中科院分区：
文献类型：
--
作者：
Shields MC
医疗保险和医疗补助服务中心于2012年实施了住院精神病设施质量报告计划，该计划公开报告了设施在限制和隔离（R-S）措施方面的表现。使用来自马萨诸塞州的数据，我们研究了非营利组织和营利组织是否对该计划的目标指标有不同的反应，以及该计划是否对所有权的非目标质量指标有不同的溢出效应。通过向马萨诸塞州提出的公共记录请求，获得了2008-2017年的R-S（有针对性）、投诉（无针对性）和出院事件。使用差异中的差异估计，我们发现营利性和非营利组织之间的R-S没有差异变化。然而，与非营利组织相比，营利组织的总体投诉、安全相关投诉、滥用相关投诉和R-S相关投诉的增幅更大。这是第一项研究，以检查国家公共报告计划的精神病设施的非针对性措施的影响。研究人员和政策制定者应进一步审查绩效报告计划的预期和非预期后果。
The Centers for Medicare and Medicaid Services implemented the Inpatient Psychiatric Facility Quality Reporting Program in 2012, which publicly reports facilities’ performance on restraint and seclusion (R-S) measures. Using data from Massachusetts, we examined whether nonprofits and for-profits responded differently to the program on targeted indicators, and if the program had a differential spillover effect on nontargeted indicators of quality by ownership. Episodes of R-S (targeted), complaints (nontargeted), and discharges were obtained for 2008–2017 through public records requests to the Commonwealth of Massachusetts. Using difference-in-differences estimators, we found no differential changes in R-S between for-profits and nonprofits. However, for-profits had larger increases in overall complaints, safety-related complaints, abuse-related complaints, and R-S-related complaints compared with nonprofits. This is the first study to examine the effects of a national public reporting program among psychiatric facilities on nontargeted measures. Researchers and policymakers should further scrutinize intended and unintended consequences of performance-reporting programs.
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