A Facility-Level Analysis of Nursing Home Compare's Five-Star Rating and Maryland's Family Satisfaction with Care Survey.

IF 4.6 2区 医学 Q1 GERONTOLOGY
Nancy Kusmaul, Roberto J Millar, Christin Diehl, Ian Stockwell
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Abstract

Background and objectives: Nursing facilities care for individuals with cognitive and/or physical disabilities. Poor quality is associated with greater disease and mortality. Quality comprises many factors and different stakeholders value different factors. This study aimed to compare two care quality frameworks, one based on observable factors and one on family satisfaction.

Research design and methods: We merged publicly available 2021 Maryland nursing facility data. The Maryland Health Care Commission surveys long-term care residents' family satisfaction across seven domains. Centers for Medicare and Medicaid Services' (CMS) 5-star ratings aggregate inspections, staffing, and quality measures. We used univariate and bivariate statistics to compare the frameworks.

Results: The data set included 220 facilities and 4,610 survey respondents. The average facility rating was 7.70/10 and overall 77% of respondents would recommend the facility. Eighty-six percent of respondents from 5-star facilities, 79% from 4-star facilities, and 76% from 3-star facilities would recommend the facility compared to 65% from 1-star facilities (p < .001, p < .01, and p < .05, respectively). Four or 5-star facilities received significantly higher ratings (8.33, p < .001; 7.75, p < .05, respectively) than 1-star facilities (7.07).

Discussion and implications: Our results corroborated earlier findings of strong associations between CMS ratings and satisfaction at the extremes of the 5-star system. These associations are inconsistent across family-reported domains. This suggests overlap between the frameworks. CMS ratings address care quality; family satisfaction measures quality of life and care quality. High satisfaction is associated with high care quality and quality of life; lower satisfaction is associated with lower care quality.

疗养院比较五星评级和马里兰州家庭护理满意度调查的设施层面分析。
背景和目标:护理机构为有认知障碍和/或肢体残疾的人提供护理。质量差与疾病和死亡率增加有关。质量由许多因素组成,不同的利益相关者重视不同的因素。本研究旨在比较两种护理质量框架,一种是基于可观察因素的框架,另一种是基于家庭满意度的框架:我们合并了公开的 2021 年马里兰州护理机构数据。马里兰州卫生保健委员会调查了长期护理居民家庭对七个领域的满意度。CMS 的五星评级综合了检查、人员配备和质量措施。我们使用单变量和双变量统计来比较这些框架:数据集包括 220 家机构和 4,610 名调查对象。设施的平均评分为 7.70/10,77% 的受访者会推荐该设施。86%的五星级医疗机构、79%的四星级医疗机构和 76%的三星级医疗机构的受访者会推荐该医疗机构,而一星级医疗机构的受访者只有 65%会推荐该医疗机构(分别为 p < 0.001、p < 0.01 和 p < 0.05)。四星级或五星级机构的评分(分别为 8.33,p < 0.001;7.75,p < 0.05)明显高于一星级机构(7.07):我们的研究结果证实了之前的研究结果,即在五星级系统的极端情况下,CMS 评级与满意度之间存在密切联系。这些关联在家庭报告的领域中并不一致。这表明两个框架之间存在重叠。CMS 评级针对的是护理质量,而家庭满意度衡量的是生活质量和护理质量。高满意度与高护理质量和生活质量相关;低满意度与低护理质量相关。
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来源期刊
Gerontologist
Gerontologist GERONTOLOGY-
CiteScore
11.00
自引率
8.80%
发文量
171
期刊介绍: The Gerontologist, published since 1961, is a bimonthly journal of The Gerontological Society of America that provides a multidisciplinary perspective on human aging by publishing research and analysis on applied social issues. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people. Articles should include a conceptual framework and testable hypotheses. Implications for policy or practice should be highlighted. The Gerontologist publishes quantitative and qualitative research and encourages manuscript submissions of various types including: research articles, intervention research, review articles, measurement articles, forums, and brief reports. Book and media reviews, International Spotlights, and award-winning lectures are commissioned by the editors.
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