Schwartz Margot L, Mroz Tracy M, Thomas Kali S
Brown University School of Public Health, Providence, RI, USA.
University of Washington, Seattle, WA, USA.
Med Care Res Rev. 2021 Dec;78(6):798-805. doi: 10.1177/1077558720968365. Epub 2020 Oct 31.
To facilitate home health agency (HHA) selection, CMS released patient experience star ratings on the Home Health Compare website in January 2016. Our objective was to understand the relationship between patient experience and outcomes in HHAs. We utilized publicly reported data to evaluate the relationships among patient experience star ratings, summary quality of care star ratings (comprised primarily of outcome measures), and individual outcome measures for 4,249 HHAs. Results indicate a weak correlation between patient experience and quality stars ( = .13, < .001). The difference between the lowest and highest rated HHAs for patient experience is associated with only a half-star improvement in quality stars. The associations between patient experience and individual outcome measures varied, with functional outcomes most strongly associated with patient experience. Findings highlight the importance of reporting separate quality domains; however, conflicting ratings may complicate the HHA selection process and introduce misaligned incentives for HHAs.
为便于家庭健康机构(HHA)的选择,医疗保险和医疗补助服务中心(CMS)于2016年1月在“家庭健康比较”网站上公布了患者体验星级评级。我们的目标是了解家庭健康机构中患者体验与结果之间的关系。我们利用公开报告的数据来评估4249家家庭健康机构的患者体验星级评级、护理质量总结星级评级(主要由结果指标组成)和个体结果指标之间的关系。结果表明,患者体验与质量星级之间的相关性较弱(r = 0.13,p < 0.001)。患者体验评级最低和最高的家庭健康机构之间的差异仅与质量星级提高半星相关。患者体验与个体结果指标之间的关联各不相同,功能结果与患者体验的关联最为紧密。研究结果凸显了报告单独质量领域的重要性;然而,相互矛盾的评级可能会使家庭健康机构的选择过程复杂化,并给家庭健康机构带来动机不一致的问题。