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The quality of quality measurement in U.S. nursing homes
Vincent Mor1, Katherine Berg, Joseph Angelelli
1Department of Community Health, Brown University School of Medicine, Box G-A418, Providence, RI 02192, USA. Vincent_Mor@brown.edu
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.