title: Does quality influence consumer choice of nursing homes? Evidence from nursing home to nursing home transfers.
abstract: We estimated Cox proportional hazards models using assessment data from the Minimum Data Set to test whether nursing home residents and their proxies respond to quality of care by changing providers. Various indicators of poor quality increased the likelihood of transfer. Residents of for-profit homes or homes with excess capacity also were more likely to transfer. Inability to participate in care decisions and factors indicating frailty limited residents' ability to transfer. The apparent responsiveness to quality is encouraging. Nonetheless, because the absolute transfer rate is low, significant barriers to movement among nursing homes still may exist.
authors.affiliation: Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. rhirth@umich.edu
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hirth
authors.forename: Jane C
authors.initials: JC
authors.lastname: Banaszak-Holl
authors.forename: Brant E
authors.initials: BE
authors.lastname: Fries
authors.forename: Marc N
authors.initials: MN
authors.lastname: Turenne
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007353:Insurance, Long-Term Care / Q000706:statistics & numerical data; D008281:Maine; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D008922:Mississippi; D009518:New York; D009735:Nursing Homes / Q000592:standards* / Q000706:statistics & numerical data*; D009820:Ohio; D010360:Patient Transfer / Q000191:economics / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D019727:Proxy / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D018570:Risk Assessment