Public Reporting and Market Area Exit Decisions by Home Health Agencies

家庭健康机构的公开报告和市场领域退出决定

• 批准号: 7771899
• 负责人: Jeah Jung
• 金额: $ 6.39万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-15 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7771899
• 关键词: Accounting; Acute; Adopted; Affect; Age; Area; Caring; Censuses; Communities; Data; Data Analyses; Disadvantaged; Economically Deprived Population; Elderly; Ensure; Equation; Frail Elderly; Geographic Locations; Health; Health Care Costs; Healthcare; Home Care Services; Home Health Agency; Home environment; Hospital Nursing; Incentives; Information Systems; Left; Marketing; Medicare; Nursing Homes; Outcome; Outcome Assessment; Patients; Policies; Policy Maker; Population; Provider; Quality of Care; Reporting; Research; Resources; Rewards; Services; Source; Techniques; Translating; Underserved Population; base; cost; design; expectation; experience; improved; programs; public health relevance; response

DESCRIPTION (provided by applicant): Public reporting of quality information has been actively promoted in health care during the past decade, with the expectation that it gives providers an incentive to improve quality. As public reporting rapidly expands to several settings, an important policy concern has been raised that public reporting may unintentionally exacerbate disparities in health care. Public reporting programs may disadvantage providers serving underserved populations, whose quality of care may be costly to improve. This implies that those providers may receive little financial rewards from public reporting programs, and to avoid this disadvantage, they may reduce services for underserved people or leave communities with those populations. Our proposed study will examine the impact of Home Health Compare (HHC), a Medicare public reporting initiative, on access to home health care among disadvantaged populations. Specifically, we will examine whether agencies selectively discontinued service to areas with socio-economically disadvantaged populations after Medicare introduced HHC in 2003. We will assess agencies' initial responses to HHC by analyzing market area exits between 2002 and 2004. We will identify agencies' service areas using the Outcome and Assessment Information System (OASIS) data and will obtain market area information from the Census file and Area Resource File (ARF). We will use logit estimation to analyze the data and will account for clustering within an agency employing the Generalized Estimating Equations (GEE) technique. The findings of this study will provide policy makers with important information that can be used to design or refine public reporting programs. PUBLIC HEALTH RELEVANCE: As demand for home health care increases, ensuring access to high quality home health care is essential. This study proposes to examine the impact of a public reporting program on access to home health care among socio-economically disadvantaged populations. Specifically, the proposed study will look at whether home health agencies discontinue service to market areas with disadvantaged populations after public reporting.

描述（由申请人提供）：在过去的十年中，医疗保健领域一直在积极推动质量信息的公开报告，期望它能激励提供者提高质量。随着公共报告迅速扩展到几个环境，一个重要的政策问题已经提出，公共报告可能无意中加剧医疗保健的差距。公共报告计划可能会使服务不足人群的提供者处于不利地位，这些人群的护理质量可能需要付出高昂的代价才能改善。这意味着这些提供者可能从公共报告计划中获得很少的经济回报，为了避免这种不利因素，他们可能会减少对服务不足的人的服务，或者让社区与这些人群在一起。我们拟议的研究将研究家庭健康比较（HHC），医疗保险公共报告倡议，对弱势群体获得家庭医疗保健的影响。具体来说，我们将研究机构是否选择性地停止服务的社会经济弱势群体的地区后，医疗保险在2003年推出HHC。我们将通过分析2002年至2004年之间的市场区域退出来评估机构对HHC的初步反应。我们将使用结果和评估信息系统（OASIS）数据确定机构的服务领域，并将从人口普查文件和地区资源文件（ARF）中获取市场区域信息。我们将使用logit估计来分析数据，并将考虑采用广义估计方程（GEE）技术的机构内的聚类。这项研究的结果将为政策制定者提供重要的信息，可用于设计或完善公共报告计划。 公共卫生相关性：随着家庭医疗保健需求的增加，确保获得高质量的家庭医疗保健至关重要。本研究旨在探讨公共报告计划对社会经济弱势群体获得家庭医疗保健的影响。具体而言，拟议的研究将着眼于家庭保健机构是否在公开报告后停止向弱势群体的市场地区提供服务。