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

描述(申请人提供)：成绩单经常显示大量消费者难以理解的复杂信息，降低消费者使用这些信息做出知情供应商选择的可能性。针对这一问题，成绩单越来越多地使用摘要或综合质量衡量标准，目的是提高消费者对成绩单的理解和反应。然而，目前尚不清楚这种方法是否成功，或者使用这些简化的衡量标准是否有权衡之处。医疗保险和医疗补助服务中心(CMS)最近从对养老院的个人质量衡量标准进行评级，改为在其基于网络的指南--对所有获得联邦医疗保险或医疗补助认证的养老院进行公开评级的--护理之家比较上使用综合“星级评级”。尽管在综合措施的使用上投入了大量资源，但尚不清楚消费者对此有何反应。一方面，更容易导航的星级评级系统可能在吸引消费者和影响他们对养老院的选择方面更有效。另一方面，星级评级系统可能会过度简化患者的选择，因为它结合了短期和长期的临床质量衡量标准，并将临床质量衡量标准与人员配备和监管缺陷结合在一起。因此，它可能会限制患者与最适合他们需求的疗养院匹配的能力。我们的具体目标是：1)评估综合和个人质量措施对消费者选择养老院的影响；2)评估综合和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在养老院质量公开报告中解释和使用综合和个人评级。为了解决这些目标，我们建议使用混合方法，包括针对目标1和目标2的疗养院最低数据集与设施特征合并的长小组(1998-2010)，以及针对目标3的半结构化访谈。本研究的目的是确定如何改进疗养院成绩单中信息的传达方式，从而提高消费者对这些信息的有效利用。

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.