Division of General Internal Medicine, Department of Medicine, University of California, Irvine, Irvine, CA, USA; iTEQC Research Program, University of California, Irvine, Irvine, CA, USA.
UCLA Borun Center at David Geffen School of Medicine, Los Angeles, CA, USA; Veterans Administration GRECC, Los Angeles, CA, USA; RAND Health, Santa Monica, CA, USA.
J Am Med Dir Assoc. 2021 Aug;22(8):1609-1614.e1. doi: 10.1016/j.jamda.2020.10.004. Epub 2020 Nov 20.
To assess (1) the relationship of consumers' assessment of overall nursing home quality to their assessment of specific dimensions of quality; and (2) the implications of this relationship for composite quality measures in Nursing Home Compare.
A survey conducted in 2017 elicited respondents' assessments of the quality of overall care and 13 specific dimensions of care.
The sample consisted of 4449 respondents who either resided in a nursing home or had a family member who resided in a nursing home during the 6 months before the survey.
We estimated regression models to infer the relationship between consumers' assessments of overall quality and 13 specific dimensions of quality. The regression coefficients, indicating the implicit importance/weight assigned by respondents to each dimension as a component of the consumers' assessment of overall quality, were used to create a prototype composite quality measure.
For long-stay residents, 8 of the 13 quality dimensions were significantly associated with their overall ratings of quality. Five dimensions achieved significance for short-stay residents. The magnitude of importance weights varied substantially across dimensions of care.
Our findings suggest that Nursing Home Compare could be improved by augmenting the technical information in the 5-Star composite measure with consumers' assessments of the additional, nontechnical dimensions of quality.
评估（1）消费者对整体疗养院质量的评估与他们对特定质量维度的评估之间的关系；以及（2）这种关系对《疗养院比较》中综合质量衡量标准的影响。
2017 年进行的一项调查征集了受访者对整体护理质量和 13 项特定护理维度的评估。
样本由 4449 名受访者组成，他们要么居住在疗养院，要么在调查前 6 个月有家庭成员居住在疗养院。
我们估计了回归模型，以推断消费者对整体质量的评估与 13 项特定质量维度之间的关系。回归系数表示受访者将每个维度作为整体质量评估的组成部分赋予的隐含重要性/权重，用于创建原型综合质量衡量标准。
对于长期居住的居民，13 项质量维度中有 8 项与他们对整体质量的评分显著相关。对于短期居住的居民，有 5 个维度具有显著意义。护理维度的重要性权重差异很大。
我们的研究结果表明，通过在五星综合衡量标准中增加消费者对额外非技术质量维度的评估，可以改进《疗养院比较》。
