Spaulding Aaron, Zhao Mei, Haley D Rob
Department of Public Health, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, United States.
Health Policy. 2014 Dec;118(3):413-21. doi: 10.1016/j.healthpol.2014.10.003. Epub 2014 Oct 16.
To determine if the Value-Based Purchasing Performance Scoring system correlates with hospital acquired condition quality indicators.
DATA SOURCES/STUDY SETTING: This study utilizes the following secondary data sources: the American Hospital Association (AHA) annual survey and the Centers for Medicare and Medicaid (CMS) Value-Based Purchasing and Hospital Acquired Conditions databases.
Zero-inflated negative binomial regression was used to examine the effect of CMS total performance score on counts of hospital acquired conditions. Hospital structure variables including size, ownership, teaching status, payer mix, case mix, and location were utilized as control variables.
The secondary data sources were merged into a single database using Stata 10.
Total performance scores, which are used to determine if hospitals should receive incentive money, do not correlate well with quality outcome in the form of hospital acquired conditions.
Value-based purchasing does not appear to correlate with improved quality and patient safety as indicated by Hospital Acquired Condition (HAC) scores. This leads us to believe that either the total performance score does not measure what it should, or the quality outcome measurements do not reflect the quality of the total performance scores measure.
确定基于价值的采购绩效评分系统是否与医院获得性疾病质量指标相关。
数据来源/研究背景：本研究利用了以下二手数据来源：美国医院协会（AHA）年度调查以及医疗保险和医疗补助服务中心（CMS）基于价值的采购和医院获得性疾病数据库。
采用零膨胀负二项回归来检验CMS总绩效评分对医院获得性疾病数量的影响。将包括规模、所有权、教学状况、付款人组合、病例组合和地理位置在内的医院结构变量用作控制变量。
使用Stata 10将二手数据来源合并到一个单一数据库中。
用于确定医院是否应获得激励资金的总绩效评分，与以医院获得性疾病形式呈现的质量结果并无良好的相关性。
如医院获得性疾病（HAC）评分所示，基于价值的采购似乎与质量改善和患者安全无关。这使我们认为，要么总绩效评分未能衡量其应衡量的内容，要么质量结果衡量未能反映总绩效评分所衡量的质量。
