Improving consumer response to nursing home quality information: An evaluation of

描述（由申请人提供）：报告卡经常显示消费者难以理解的大量复杂信息，降低了消费者使用这些信息做出明智的供应商选择的可能性。为了解决这个问题，报告卡越来越多地使用质量的汇总或综合衡量标准，目的是增加消费者对报告卡的理解和反应。然而，目前还不清楚这种方法是否成功，或者使用这些简化的措施是否存在权衡。医疗保险和医疗补助服务中心（CMS）最近从根据个人质量标准对疗养院进行评级，转向使用疗养院比较的综合“星星评级”，这是一个基于网络的指南，公开对所有医疗保险或医疗补助认证的疗养院进行评级。 尽管在使用综合衡量标准方面投入了大量资源，但消费者对此的反应如何尚不清楚。一方面，从服务员到导航的星星评级系统可能更有效地吸引消费者并影响他们对养老院的选择。另一方面，星星评级系统可能会过度简化患者的选择，因为它将短期和长期住院的临床质量措施结合起来，并将临床质量措施与人员配备和监管缺陷结合起来。因此，这可能会限制病人与最适合他们需求的养老院相匹配的能力。我们的具体目标是：1）评估综合与个人质量措施对消费者的养老院选择的影响，2）评估综合与个人质量措施对消费者与养老院匹配的影响，3）定性评估消费者如何解释和使用综合与个人评级在养老院质量的公开报告。为了解决这些目标，我们建议使用混合的方法，包括一个长面板（1998-2010年）的养老院最小数据集合并设施的特点，目标1和2，和半结构化的采访目标3。本研究的目的是确定如何改善信息是如何传达在养老院报告卡，从而提高消费者的有效利用这些信息。 公共卫生相关性：虽然公共报告卡的目的是改善消费者对提供者的选择，但消费者往往不使用这些报告卡，这限制了它们在提高医疗保健质量方面的有效性。这个项目测试的效果，一个常用的方法，以提高消费者使用的报告卡信息的综合措施的使用。通过测试消费者对养老院质量综合指标的反应，该项目将直接为未来创建更有效的报告卡提供信息。

DESCRIPTION (provided by applicant): Report cards frequently display large amounts of complex information that consumers have difficulty understanding, decreasing the likelihood that consumers will use the information to make informed provider choices. In response to this problem, report cards are increasingly using summary or composite measures of quality with the goal of increasing consumer comprehension of and response to report cards. Yet it is unknown whether this approach has been successful or if there are tradeoffs to using these simplified measures. The Centers for Medicare and Medicaid Services (CMS) recently switched from rating nursing homes on individual quality measures to using a composite "star rating" on Nursing Home Compare, its web-based guide that publicly rates all Medicare- or Medicaid-certified nursing homes. Despite the significant resources that have been invested in the use of composite measures, it is unknown how consumers have responded to them. On one hand, the easier-to-navigate star rating system may be more effective in engaging consumers and influencing their choice of nursing homes. On the other hand, the star rating system may oversimplify patients' choice, as it combines short- and long-stay clinical quality measures and combines clinical quality measures with staffing and regulatory deficiencies. It thus may limit patients' ability to match with nursing homes that best suit their needs. Our specific aims are 1) To evaluate the effect of composite vs. individual quality measures on consumer's nursing home choice, 2) To evaluate the effect of composite vs. individual quality measures on matching of consumers to nursing homes, and 3) To assess qualitatively the how consumers interpret and use composite vs. individual ratings in public reporting of nursing home quality. To address these aims we propose to use mixed methods, including a long panel (1998-2010) of the nursing home Minimum Data Set merged with facility characteristics for Aims 1 and 2, and semi-structured interviews for Aim 3. The goal of this research is to identify ways to improve how the information is conveyed in nursing home report cards and thus increase consumers' effective use of this information. PUBLIC HEALTH RELEVANCE: Although public report cards are intended to improve consumers' choice of providers, they are often not used by consumers, limiting their effectiveness in improving health care quality. This project tests the effect of one commonly used method to improve consumer use of report card information-the use of composite measures. By testing consumer response to composite measures of nursing home quality this project will directly inform future efforts to create more effective report cards.