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Facility-level outcome performance measures for nursing homes

F Porell1, F G Caro

  • 1Gerontology Institute, University of Massachusetts, Boston 02125-3393, USA. porell@umbsky.cc.umb.edu

The Gerontologist
|December 30, 1998
PubMed
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Nursing home performance scores, based on health outcomes and quality indicators, showed limited consistency over time. These risk-adjusted measures have implications for quality assurance and reimbursement strategies.

Area of Science:

  • Gerontology
  • Health Services Research
  • Quality Improvement

Background:

  • Nursing home quality assessment is crucial for patient care and resource allocation.
  • Existing performance measures require refinement for accuracy and reliability.
  • Longitudinal data analysis offers insights into facility performance trends.

Purpose of the Study:

  • To develop and evaluate risk-adjusted nursing home performance scores.
  • To assess the consistency and predictability of facility performance over time.
  • To explore the relationship between performance measures and facility attributes.

Main Methods:

  • Utilized resident-level longitudinal case-mix reimbursement data from over 500 Massachusetts nursing homes (1991-1994).
  • Developed risk-adjusted scores for four health outcomes and five quality indicators.

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  • Employed econometric models for quarterly outcome predictions and performance comparisons.

    • Main Results:

    • Performance measures were narrowly distributed across facilities.
    • Intercorrelations among the nine performance measures were low and not consistently positive.
    • Longitudinal analyses indicated modest correlations in performance scores over time, with few facilities showing consistent high or low performance.

    Conclusions:

    • Risk-adjusted performance measures show limited stability over time.
    • Facility performance is not strongly associated with structural attributes.
    • Findings suggest caution in using current outcome performance measures for quality assurance and reimbursement.