Mukamel Dana B, Amin Alpesh, Weimer David L, Sharit Joseph, Ladd Heather, Sorkin Dara H
Dana B. Mukamel (
Alpesh Amin is a chair and professor in the Department of Medicine as well as executive director of the Hospitalist Program at the University of California, Irvine.
Health Aff (Millwood). 2016 Apr;35(4):714-9. doi: 10.1377/hlthaff.2015.1340.
Report cards currently published by the Centers for Medicare and Medicaid Services (CMS) offer composite (summary) quality measures based on a five-star ratings system, such as the one featured on the Nursing Home Compare website. These ratings are "one size fits all patients" measures. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. We present data from 146 patients who were discharged from the hospital to nursing homes who used Nursing Home Compare Plus. We found that the individual patient-constructed composites differed from CMS's five-star ratings composite. Patients differed from each other and from CMS in the number of performance measures they chose to include in their composite and in their weighting of each performance measure. When comparing Nursing Home Compare Plus to Medicare's five-star ratings, we found only minimal agreement on ranking of nursing homes. We conclude that patients might benefit if current report cards are modified to include an option for personalized ranking.
医疗保险和医疗补助服务中心（CMS）目前发布的成绩单提供基于五星级评级系统的综合（汇总）质量指标，比如“护理院比较”网站上展示的那种。这些评级是“一刀切适用于所有患者”的指标。“护理院比较升级版”则提供了另一种选择，它允许患者及其家属根据自身偏好和医疗需求创建自己的综合评分。我们展示了146名从医院出院后入住使用了“护理院比较升级版”的养老院的患者的数据。我们发现，患者个人构建的综合指标与CMS的五星级评级综合指标有所不同。患者之间以及与CMS之间在他们选择纳入综合指标的绩效指标数量以及对每个绩效指标的权重方面存在差异。在将“护理院比较升级版”与医疗保险的五星级评级进行比较时，我们发现养老院排名方面的一致性极低。我们得出结论，如果对当前的成绩单进行修改，纳入个性化排名选项，患者可能会从中受益。
