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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
Journal of the American Medical Directors Association
|March 14, 2007
Summary
Public reporting of comparative quality data in US health care is growing. However, challenges exist in using this data to accurately judge and compare nursing home and home health agency quality.
Area of Science:
- Health Services Research
- Quality Improvement
- Long-Term Care
Background:
- Growing consensus in the US health care industry on the necessity of quality of care information sharing.
- Mandated, uniform clinical data availability in nursing homes and home health agencies has enabled public reporting of comparative quality data.
Purpose of the Study:
- To examine the conceptual and technical challenges in applying long-term care quality data.
- To assess the validity of using quality "tools" for provider selection and performance rewards.
Main Methods:
- Analysis of conceptual and technical challenges in quality data application.
- Review of evidence supporting the use of mandated clinical assessments for judging provider quality.
Main Results:
- The drive to utilize quality data for comparing long-term care providers may exceed current evidence of validity.
- Potential limitations in using mandated clinical assessments for selecting top-performing nursing homes and home health agencies.
Conclusions:
- Further research is needed to validate the application of quality "tools" in long-term care.
- Careful consideration of evidence is required before using comparative quality data for provider selection or rewards.
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