The Quality of Quality Measurement in U.S. Nursing Homes
Open Access
- 1 April 2003
- journal article
- research article
- Published by Oxford University Press (OUP) in The Gerontologist
- Vol. 43 (suppl_2) , 37-46
- https://doi.org/10.1093/geront/43.suppl_2.37
Abstract
Purpose:This article examines various technical challenges inherent in the design, implementation, and dissemination of health care quality performance measures.Design and Methods:Using national and state-specific Minimum Data Set data from 1999, we examined sample size, measure stability, creation of ordinal ranks, and risk adjustment as applied to aggregated facility quality indicators.Results:Nursing home Quality Indicators now in use are multidimensional and quarterly estimates of incidence-based measures can be relatively unstable, suggesting the need for some averaging of measures over time. Implications:Current public reports benchmarking nursing homes' performances may require additional technical modifications to avoid compromising the fairness of comparisons.Keywords
This publication has 30 references indexed in Scilit:
- Pain in U.S. Nursing HomesThe Gerontologist, 2001
- Scaling ADLs Within the MDSThe Journals of Gerontology: Series A, 1999
- Gender differences in the relation between comorbidity and mortality of patients with Alzheimer’s diseaseNeurology, 1999
- Is Health Care Ready for Six Sigma Quality?The Milbank Quarterly, 1998
- Statistical Methods for Profiling Providers of Medical Care: Issues and ApplicationsJournal of the American Statistical Association, 1997
- Quality Improvement Activity Directed at the National LevelQuality Management in Health Care, 1997
- Influence of Cardiac-Surgery Performance Reports on Referral Practices and Access to Care — A Survey of Cardiovascular SpecialistsNew England Journal of Medicine, 1996
- What Information Do Consumers Want and Need?Health Affairs, 1996
- An Empirical Test of the Structure, Process, and Outcome Quality Paradigm Using Resident-Based, Nursing Facility Assessment DataAmerican Journal of Medical Quality, 1995
- Reliability Estimates for The Minimum Data Set for Nursing Home Resident Assessment and Care Screening (MDS)The Gerontologist, 1995