养老机构对“养老机构比较”的反应：提供者视角。
Nursing Home Response to Nursing Home Compare: The Provider Perspective.
机构信息
1 University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
2 University of Chicago, Chicago, IL, USA.
出版信息
Med Care Res Rev. 2019 Aug;76(4):425-443. doi: 10.1177/1077558717725165. Epub 2017 Aug 11.
Nursing Home Compare (NHC) publishes composite quality ratings of nursing homes based on a five-star rating system, a system that has been subject to controversy about its validity. Using in-depth interviews, we assess the views of nursing home administrators and staff on NHC and unearth strategies used to improve ratings. Respondents revealed conflicting goals and strategies. Although nursing home managers monitor the ratings and expend effort to improve scores, competing goals of revenue maximization and avoidance of litigation often overshadow desire to score well on NHC. Some of the improvement strategies simply involve coding changes that have no effect on resident outcomes. Many respondents doubted the validity of the self-reported staffing data and stated that lack of risk adjustment biases ratings. Policy makers should consider nursing home incentives when refining the system, aiming to improve the validity of the self-reported domains to provide incentives for broader quality improvement.
养老院比较（Nursing Home Compare，NHC）根据五星评级系统发布养老院的综合质量评级，该系统的有效性一直存在争议。我们通过深入访谈，评估了养老院管理人员和工作人员对 NHC 的看法，并挖掘了提高评级的策略。受访者揭示了相互矛盾的目标和策略。尽管养老院经理会监测评级并努力提高分数，但最大化收入和避免诉讼的竞争目标往往会掩盖在 NHC 上取得好成绩的愿望。一些改进策略仅仅涉及对没有对居民结果产生影响的编码更改。许多受访者怀疑自我报告的人员配备数据的有效性，并表示缺乏风险调整会使评级产生偏差。政策制定者在完善该系统时应考虑养老院的激励措施，旨在提高自我报告领域的有效性，以激励更广泛的质量改进。
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