Konetzka R Tamara, Perraillon Marcelo Coca
R. Tamara Konetzka (
Marcelo Coca Perraillon is an assistant professor in the Department of Health Systems, Management, and Policy at the Colorado School of Public Health, University of Colorado Anschutz Medical Campus, in Aurora.
Health Aff (Millwood). 2016 Apr;35(4):706-13. doi: 10.1377/hlthaff.2015.1377.
In December 2008 the Centers for Medicare and Medicaid Services (CMS) launched a five-star rating system of nursing homes as part of Nursing Home Compare, a web-based report card detailing quality of care at all CMS-certified nursing homes. Questions remain, however, as to how well consumers use this rating system as well as other sources of information in choosing nursing home placement. We used a qualitative assessment of how consumers select nursing homes and of the role of information about quality, using semistructured interviews of people who recently placed a family member or friend in a nursing home. We found that consumers were receptive to using Internet-based information about quality as one source of information but that choice was limited by the need for specialized services, proximity to family or health care providers, and availability of Medicaid beds. Consumers had a positive reaction when shown Nursing Home Compare; however, its use appeared to be limited by lack of awareness and, to some extent, initial lack of trust of the data. Our findings suggest that efforts to expand the use of Nursing Home Compare should focus on awareness and trust. Useful additions to Nursing Home Compare might include measures of the availability of activities, information about cost, and consumer satisfaction.
2008年12月，医疗保险和医疗补助服务中心（CMS）推出了一项养老院五星级评级系统，作为“养老院比较”项目的一部分，这是一份基于网络的成绩单，详细列出了所有经CMS认证的养老院的护理质量。然而，关于消费者在选择养老院安置时如何有效使用该评级系统以及其他信息来源，仍存在疑问。我们通过对消费者如何选择养老院以及质量信息所起作用进行定性评估，采用半结构化访谈的方式，采访了最近将家庭成员或朋友安置在养老院的人。我们发现，消费者愿意将基于互联网的质量信息作为一种信息来源，但选择受到专业服务需求、与家人或医疗服务提供者的距离以及医疗补助床位可用性的限制。向消费者展示“养老院比较”时，他们有积极的反应；然而，其使用似乎受到认知度不足以及在某种程度上对数据最初缺乏信任的限制。我们的研究结果表明，扩大“养老院比较”使用范围的努力应集中在提高认知度和增强信任上。对“养老院比较”有用的补充内容可能包括活动可用性的衡量标准、费用信息以及消费者满意度。
