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.

 描述（由申请人提供）：质量报告卡旨在告知消费者，增加质量需求弹性，增强竞争，从而导致质量改进。迄今为止的证据表明，一些报告卡，如CMS护理之家比较（NHC），可能达不到这些目标，因为它们提供的信息的复杂性。NHC包括有关人员配备，缺陷引用和18个质量措施（QM）的信息。这些信息的大量提出了一个挑战，消费者在选择养老院。在先前的研究中，人们已经证明，当他们有综合质量的多个维度并简化决策过程的汇总度量时，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，CMS于2008年推出了“5星星”系统。它提供了沿着4个维度的汇总测量：1）总体评级; 2）基于QM的评级; 3）基于人员配置的评级; 4）基于缺陷的评级。摘要计量中每个组成部分的相对权重反映了CMS召集的专家小组提出的偏好和建议。 这项建议的动机是认识到，专家小组可能不代表“平均”养老院居民或家庭成员，谁是实际的决策者。因此，本提案的目的是获取最近有疗养院入住经验的个人的偏好，并使用这些偏好来开发和测试替代的、消费者驱动的“5星星”系统。 为了实现这一目标的调查将管理一个大的国家样本的受访者最近疗养院入院的经验。该调查将引起关于养老院质量的偏好，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，以便检验关于偏好对这些因素的依赖性的假设。这些信息，连同从MDS和OSCAR文件计算的质量措施，将用于开发两个替代的综合排名系统。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星星”排名进行比较。 该项目将提供信息，可以指导未来改进“5星星”系统， 2010年《患者保护和平价医疗法案》（Patient Protection and Affordable Care Act）此外，它还响应了“提高保健质量国家战略”中的优先事项，该战略强调以病人和家庭的偏好为指导，以病人为中心的护理。