A National Report of Nursing Home Quality Measures and Information Technology

国家疗养院质量措施和信息技术报告

• 批准号: 8610452
• 负责人: Gregory L. Alexander
• 金额: $ 98.3万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2017-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8610452
• 关键词: National; Report; Nursing; Home; Quality

Abstract: In this National Report of Nursing Home Quality Measures and Information Technology AHRQ will support an interdisciplinary research team who are already contributing to clinical research in long-term care settings. The PI is a doctorally-prepared RN and fellow in the American Academy of Nursing with over two decades of work in diverse projects, settings, and disciplines. The research strategy includes a three-wave, longitudinal, repeated measures study measuring Information Technology Sophistication (ITS) in a national sample of nursing homes (NH). Methods include an examination of the relationships between NH ITS and nationally- reported, publicly-available NH Quality Measures available through Nursing Home Compare and OSCAR over three consecutive years. Specific aims are: 1) Describe the pattern of changes in overall ITS determined by changes in overall ITS over time and examine links between the changes in ITS and NH attributes, 2) Examine whether patterns of overall ITS changes are associated with the changes in Quality Measure scores over 3 years, and 3) Investigate relationships between specific types of ITS scores (Domains and Dimensions), NH attributes (Staffing, Facility, and Market Characteristics), and NH Quality Measures. ITS has been used to describe the diversity of IT and software used to support three domains of health care including Resident Care, Clinical Support, and Administrative Activities. Reported Quality Measures are risk-adjusted to account for variations in resident acuity so that care delivered in each facility can be compared. The project is highly innovative; national assessments of NH IT have not been linked previously with national NH Quality Measures. This study includes a survey of ITS in a nationally representative sample including 10% of NHs recruited from each state in the United States (N=1,570). We will incorporate a mixed model approach in our analysis including NH Quality Measures as the dependent, and Time and 9 different types of ITS as independent variables, respectively. In Aim 1 we will assess NH ITS measured in three dimensions (Functional, Technological, and Integration) including types of IT used, extent of use of IT, and degree of external and internal IT integration, respectively. ITS will also be measured in three health care domains including Resident Care, Clinical Support, and Administrative Activities. In Aim 2, we will examine associations between NH ITS, select NH attributes, and nationally reported Nursing Home Compare Quality Measures. We will characterize patterns of overall ITS over 3 years as increasing, stable, decreasing, or unstable (erratic). We will integrate classical econometric methods to correct for potential endogeneity of IT by using NH attributes including Staffing, Facility, and Market Characteristics as covariates in a mixed model approach including multivariate regression, dynamic panel model analysis, and an instrumental variable technique.

抽象的： 在这份国家疗养院质量措施和信息技术的国家报告中，AHRQ将支持 已经在长期护理环境中为临床研究做出贡献的跨学科研究团队。这 PI是一位精心准备的RN，是美国护理学院的研究员，有二十年的工作 在不同的项目，设置和学科中。研究策略包括三波，纵向 重复措施研究在国家样本中测量信息技术复杂（ITS） 疗养院（NH）。方法包括检查NH ITS与全国之间的关系 - 报告，可公开可用的NH质量措施可通过疗养院进行比较和奥斯卡 连续三年。具体目的是：1）描述其总体变化的模式由 整体随着时间的时间变化并检查其属性和NH属性的变化之间的联系，2）检查 整体变化的模式是否与3个以上的质量度量得分的变化有关 年，3）研究其特定类型的分数（域和维度）之间的关系，NH 属性（人员配备，设施和市场特征）和NH质量措施。它习惯了 描述IT的多样性和用于支持三个卫生保健领域的软件，包括居民护理， 临床支持和行政活动。报告的质量措施被调整为风险 居民敏锐度的变化可以比较在每个设施中提供的护理。该项目高度 创新的;国家对NH的评估以前尚未与国家NH质量措施有关。 这项研究包括在全国代表性样本中对其的调查，包括10％的NHS 美国的每个州（n = 1,570）。我们将在分析中纳入混合模型方法 包括NH质量措施作为依赖，时间和9种不同类型的独立 变量分别。在AIM 1中，我们将在三个维度（功能， 技术和集成）包括使用的类型，IT的使用程度以及外部和外部和程度 内部IT集成。它也将在包括居民在内的三个医疗保健领域中进行衡量 护理，临床支持和行政活动。在AIM 2中，我们将研究NH ITS之间的关联 选择NH属性，并在全国报道的疗养院比较质量措施。我们将表征 总体上3年的整体模式随着增加，稳定，减少或不稳定（不稳定）的模式。我们将整合 经典计量经济学方法通过使用NH属性在内 混合模型方法中的协变量，包括多变量的配置，设施和市场特征 回归，动态面板模型分析和仪器变量技术。