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Published on: February 16, 2011
Defining and measuring quality outcomes in long-term care
1Department of Community Health and Center for Gerontology and Health Care Research, Brown University School of Medicine, Providence, RI 02192, USA. vincent_mor@brown.edu <vincent_mor@brown.edu>
Journal of the American Medical Directors Association
|October 10, 2006
Summary
Public reporting of nursing home and home health agency quality data is growing. However, challenges exist in using this data to accurately compare provider performance and reward superior care.
Area of Science:
- Health Services Research
- Gerontology
- Health Informatics
Background:
- Growing consensus in the US health care industry emphasizes the need for quality of care information sharing to drive provider improvement.
- Mandated, uniform clinical data collection in nursing homes and home health agencies has enabled widespread public reporting of comparative quality metrics.
Purpose of the Study:
- To examine the conceptual and technical challenges associated with using long-term care quality data for judging and comparing nursing homes and home health agencies.
- To assess the validity of current quality 'tools' derived from mandated clinical assessments for provider selection and performance rewards.
Main Methods:
- Conceptual analysis of the application of quality data in long-term care settings.
- Examination of technical challenges in data utilization for comparative quality assessment.
Main Results:
- The rapid adoption of public reporting of comparative quality data has been facilitated by mandated clinical assessments.
- The evidence supporting the valid application of these quality tools for selecting top providers or rewarding superior performance may be insufficient.
Conclusions:
- While quality data sharing is increasing, significant conceptual and technical hurdles remain in its application for evaluating long-term care providers.
- The drive to utilize quality assessment tools may have outpaced the evidence base for their effectiveness in provider comparison and reward systems.
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