Public reporting on quality of care has definite, if modest, effects on nursing home care improvement
Research Activities, January 2011, No. 365
Public reporting of information about the quality of care delivered by health care providers is thought to improve quality in two ways: (1) consumers will be more likely to choose high quality providers, and (2) providers will have an incentive to invest in and improve the quality of care. A new study found that public reporting drove modest gains in nursing home care quality. A team of researchers headed by Rachel Werner, M.D., Ph.D., of the University of Pennsylvania, studied 8,137 nursing homes and 1,843,377 postacute stays for the 12 months before and after the Nursing Home Compare public reporting requirements went into effect. The nursing homes were measured on three postacute care quality measures: the percentages of short-stay patients who did not have moderate or severe pain, who were without delirium, and whose walking improved. The percentage of patients who were without moderate or severe pain increased from 73.8 percent to 77.3 percent with public reporting.
Nursing home-specific improvements in quality accounted for 2.4 percent of the increase, and an increased number of patients choosing high-quality nursing homes (increased market share) accounted for 1.6 percent. Residual changes in quality reduced the total by 0.5 percentage points. The percentage of patients without delirium increased only slightly from 96.2 to 96.5 percent since a 2.9 percent increase in market share was almost canceled out by residual changes of 2.7 percent. There were no overall changes in the percentage of patients with improved walking, since, once again, gains in quality and market share were canceled out by residual changes. This study was supported by the Agency for Healthcare Research and Quality (HS16478).
See "Public reporting drove quality gains at nursing homes," by Dr. Werner, Elizabeth Stuart, Ph.D., and Daniel Polsky, M.D., in the September 2010 Health Affairs 29(9), pp. 1706-1713.