Evaluating the impact of patient-centric home health quality reports

描述（由申请人提供）：州和国家公共报告计划的运作假设是，医疗保健信息的公开发布可以提高质量，尽管几乎没有证据表明医疗保健消费者经常使用这些数据来做出决定。研究对于创建以消费者为中心的公共报告是必要的，这些报告使消费者能够访问，理解和使用高质量的数据来比较供应商并做出选择。以消费者为中心的公共报告对于家庭医疗保健特别及时和必要，因为州和国家政策鼓励提供者和支付者确保患者在限制最少的环境中接受护理。这包括将弱势患者从长期护理转移到社区和家庭健康服务，同时实施旨在减少不必要的医疗保健利用和降低支出的计划。这些政策和人口老龄化结合在一起，大大增加了居住在社区的慢性病患者的数量，他们依靠家庭医疗服务来优化他们的健康和医疗保健，同时降低成本。该项目将联合收割机的专业知识的研究人员在健康中心的顾问和布朗大学。使用焦点小组，结构化访谈，认知为基础的测试和随机对照试验（RCT）设计，我们的目标是：（患者和护理人员）和医院病例管理人员使用当前的公开报告内容和格式，以及他们建议进行哪些更改以增加其使用频率和决策效用;评估消费者和案例管理人员查看修订后的、以消费者为中心的、基于网络的公共报告时是否理解信息以及如何使用信息;并评估患者在出院前是否使用新的以消费者为中心的报告信息来选择更高的-执行家庭健康机构和体验更好的满意度和结果相比，消费者提供了旧的格式。我们的项目将有助于改善AHRQ在公共报告证据库中确定的三个差距中的两个：（1）改进公共报告的设计和呈现，以满足消费者的需求;（2）改进公共报告的内容和方法，使报告更可信，更有意义，对消费者决策更有用。除了生成可以转化为其他报告工作的知识外，我们还将估计我们的报告格式对家庭健康消费者满意度和结果的影响，包括对州和联邦政策制定者具有重大成本避免影响的利用措施。

DESCRIPTION (provided by applicant): State and national public reporting programs operate under the assumption that the public release of healthcare information improves quality, although there is little evidence that healthcare consumers routinely use these data to make decisions. Research is necessary to create consumer-centric public reports that empower and enable consumers to access, understand and use quality data to compare providers and make choices. Consumer-centric public reports are especially timely and necessary for home health care, given state and national policies that encourage providers and payers to ensure that patients receive care in the least-restrictive setting possible. This includes shifting vulnerable patients from long-term care to community and home health services, while simultaneously implementing programs designed to reduce unnecessary healthcare utilization and lower expenditures. Taken together, these policies and the aging population are combining to significantly increase the numbers of chronically ill patients residing in the community and relying on home health services to optimize their health and health care, while lowering costs. This project will combine the expertise of researchers at Health centric Advisors and Brown University. Using focus groups, structured interviews, cognitive-based testing and a randomized, controlled trial (RCT) design, our aims are to: determine how home health consumers (patients and caregivers) and hospital case managers use the current public reporting content and format, and what changes they recommend to increase its frequency of use and decision-making utility; evaluate whether or not consumers and case managers who view a revised, consumer-centric, web-based public report understand the information and how to use it; and evaluate whether or not patients offered a new consumer-centric report prior to hospital discharge use the information to choose higher-performing home health agencies and experience better satisfaction and outcomes compared to consumers offered the old format. Our project will help to improve two of the three gaps that AHRQ has identified in the public reporting evidence base: (1) improving the design and presentation of public reports to meet the needs of consumers and (2) improving public reporting content and methodology to make reports more credible, meaningful and useful for consumer decision making. In addition to generating knowledge that can be translated to other reporting efforts, we will estimate the impact of our reporting format on home health consumers' satisfaction and outcomes, including utilization measures that have significant cost avoidance implications for state and federal policymakers.