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Assessing Community Quality of Health Care.
Jeph Herrin1,2, Kevin Kenward1, Maulik S Joshi1
1Health Research & Educational Trust, Chicago, IL.
Health Services Research
|June 23, 2015
Summary
Quality of care in hospitals, nursing homes (NHs), and home health agencies (HHAs) varies significantly by region and is not correlated across settings. Identifying communities with high quality requires examining all care dimensions, not just hospital performance.
Area of Science:
- Healthcare quality assessment
- Comparative effectiveness research
- Health services research
Background:
- Assessing healthcare quality across different settings (hospitals, nursing homes, home health agencies) is complex.
- Understanding regional variations in care quality is crucial for targeted improvements.
Purpose of the Study:
- To evaluate the agreement of quality measures across hospitals, nursing homes (NHs), and home health agencies (HHAs).
- To identify communities with high-quality care across all three settings.
Main Methods:
- Utilized publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs).
- Constructed composite quality measures and identified HSAs with high or low quality across all settings.
- Compared these HSAs based on sociodemographic and health system factors.
Main Results:
- Identified distinct quality dimensions for hospitals (3), HHAs (4), and NHs (2), with poor correlation between settings.
- HSAs with high quality across all settings had more general practitioners and fewer specialists per capita compared to those with high hospital quality only.
Conclusions:
- High-quality hospital, HHA, and NH care are not consistently correlated at the regional level.
- Regions excelling in all care dimensions differ significantly from those excelling only in hospital care or in none.
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