Improving quality report cards through inclusion of consumers preferences

通过纳入消费者偏好来提高报告卡质量

• 批准号: 9103796
• 负责人: DANA B MUKAMEL
• 金额: $ 65.02万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9103796
• 关键词: Address; Admission activity; Affordable Care Act; Characteristics; Charge; Clinical; Congresses; Consumer Preferences; Data; Data Analyses; Data Collection; Decubitus ulcer; Dependence; Development; Dimensions; Economics; Effectiveness; Elasticity; Equilibrium; Failure; Family; Family member; Federal Government; Future; Government; Health; Health Status; Healthcare; Healthcare Market; Home environment; Hospitals; Incentives; Individual; Insurance; Lead; Marketing; Measures; Methodology; Modification; Nature; Nursing Homes; Patient-Centered Care; Patients; Price; Process; Provider; Publishing; Quality of Care; Recommendation; Reporting; Respondent; Sampling; Surveys; System; Techniques; Testing; Weight; base; cost; design; experience; falls; hedonic; improved; information gathering; mental state; preference; prospective; public health relevance; response; socioeconomics; statistics; success

 DESCRIPTION (provided by applicant): Quality report cards are intended to inform consumers, increase the demand elasticity for quality, enhance competition and as a result lead to quality improvement. Evidence to-date suggests that some report cards, such as the CMS Nursing Home Compare (NHC), may fall short on reaching these objectives because of the complexity of the information they provide. NHC includes information about staffing, deficiency citation and 18 Quality Measures (QMs). This large amount of information presents a challenge to consumers when choosing a nursing home. Individuals have been shown in prior studies to be able to make better choices when they have summary measures that integrate the multiple dimensions of quality and simplify their decision process. Recognizing this need, and in response to a request from Congress, CMS introduced the "5 Star" system in 2008. It offers summary measures along 4 dimensions: 1) an overall rating; 2) ratings based on QMs; 3) ratings based on staffing; 4) ratings based on deficiencies. The relative weights of each component in the summary measures reflect the preferences and recommendations made by an expert panel convened by CMS. This proposal is motivated by the recognition that an expert panel may not be representative of the "average" nursing home resident or family members, who are the actual decision makers. Therefore, the objective of this proposal is to elicit preferences of individuals with recent nursing home admission experience and use those preferences to develop and test alternative, consumer-driven, "5 Star" systems. To achieve this objective a survey will be administered to a large national sample of respondents with recent nursing home admission experience. The survey will elicit preferences with respect to nursing home quality, utilizing hedonic pricing and contingent valuation techniques. It will also gather information about socio-demographic, economic and health status to allow tests of hypotheses regarding the dependence of preferences on these factors. This information, in conjunction with quality measures calculated from the MDS and OSCAR files, will be used to develop two alternative composite ranking systems. The rankings based on hedonic pricing and contingent valuations would be compared to each other and to the "5 Star", expert panel based rankings. This project will offer information that could guide future improvements to the "5 Star" system, as called for by the Patient Protection and Affordable Care Act of 2010 (ACA). Furthermore, it is responsive to the priorities included in the "National Strategy for Quality Improvement in Health Care," which emphasizes patient and family preferences as guiding patient centered care.

 说明(申请人提供)：质量成绩单旨在告知消费者，增加质量需求弹性，增强竞争力，从而促进质量改进。到目前为止的证据表明，一些成绩单，如CMS养老院比较(NHC)，可能达不到这些目标，因为它们提供的信息很复杂。NHC包括有关人员配备、不足引用和18项质量措施(QMS)的信息。这些海量信息给消费者在选择养老院时提出了挑战。先前的研究表明，当个人拥有综合质量的多个维度并简化他们的决策过程的总结措施时，他们能够做出更好的选择。认识到这一需要，并应国会的要求，合作医疗在2008年引入了“五星”系统。它提供了4个维度的综合衡量标准：1)总体评级；2)基于质量管理体系的评级；3)基于人员配备的评级；4)基于缺陷的评级。摘要措施中每个组成部分的相对权重反映了合作机制召集的一个专家小组提出的偏好和建议。这一建议的动机是认识到，专家小组可能不能代表疗养院居民或家庭成员的“普通”，他们是实际的决策者。因此，这项建议的目标是吸引最近有疗养院入院经验的个人的偏好，并利用这些偏好开发和测试替代的、由消费者驱动的“五星”系统。为了实现这一目标，将对最近有疗养院入院经验的受访者进行全国大样本调查。调查将引出对养老院质量的偏好，利用享乐定价和条件估值技术。它还将收集有关社会人口、经济和健康状况的信息，以测试有关偏好对这些因素的依赖性的假设。这些信息与根据MDS和OSCAR文件计算的质量衡量一起，将用于开发两个备选综合排名系统。基于享乐定价和或有估值的排名将相互比较，并与基于专家小组的“5星”排名进行比较。该项目将提供信息，指导今后改进“五星”系统，如 2010年《患者保护和平价医疗法案》(ACA)的要求。此外，它还响应了“国家卫生保健质量改进战略”中的优先事项，该战略强调以患者和家庭的偏好为指导，以患者为中心的护理。