{"title":"Measuring Nursing Home Performance Using Administrative Data.","authors":"Bram Wouterse, Pieter Bakx, Albert Wong","doi":"10.1177/10775587221108247","DOIUrl":null,"url":null,"abstract":"<p><p>To improve the quality of nursing home care, reliable estimates of outcomes are essential. Obtaining such estimates requires optimal use of limited data, especially for small homes. We analyze the variation in mortality and hospital admissions across nursing homes in the Netherlands during the years 2010-2013. We use administrative data on all nursing home clients. We apply mixed-effects survival models, empirical Bayes estimation, and machine-learning techniques to optimally use the available longitudinal data. We find large differences in both outcomes across nursing homes, yet the estimates are surrounded by substantial uncertainty. We find no correlation between performance on mortality and avoidable hospital admissions, suggesting that these are related to different aspects of quality. Hence, caution is needed when evaluating the performance of individual nursing homes, especially when the number of outcome indicators is limited.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":"80 2","pages":"187-204"},"PeriodicalIF":2.4000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10009495/pdf/","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Care Research and Review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10775587221108247","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 3
Abstract
To improve the quality of nursing home care, reliable estimates of outcomes are essential. Obtaining such estimates requires optimal use of limited data, especially for small homes. We analyze the variation in mortality and hospital admissions across nursing homes in the Netherlands during the years 2010-2013. We use administrative data on all nursing home clients. We apply mixed-effects survival models, empirical Bayes estimation, and machine-learning techniques to optimally use the available longitudinal data. We find large differences in both outcomes across nursing homes, yet the estimates are surrounded by substantial uncertainty. We find no correlation between performance on mortality and avoidable hospital admissions, suggesting that these are related to different aspects of quality. Hence, caution is needed when evaluating the performance of individual nursing homes, especially when the number of outcome indicators is limited.
期刊介绍：
Medical Care Research and Review (MCRR) is a peer-reviewed bi-monthly journal containing critical reviews of literature on organizational structure, economics, and the financing of health and medical care systems. MCRR also includes original empirical and theoretical research and trends to enable policy makers to make informed decisions, as well as to identify health care trends. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 25 days
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