Where should Momma go? Current nursing home performance measurement strategies and a less ambitious approach.
BACKGROUND
Nursing home performance measurement systems are practically ubiquitous. The vast majority of these systems aspire to rank order all nursing homes based on quantitative measures of quality. However, the ability of such systems to identify homes differing in quality is hampered by the multidimensional nature of nursing homes and their residents. As a result, the authors doubt the ability of many nursing home performance systems to truly help consumers differentiate among homes providing different levels of quality. We also argue that, for consumers, performance measurement models are better at identifying problem facilities than potentially good homes.


CONCLUSIONS
In response to these concerns we present a proposal for a less ambitious approach to nursing home performance measurement than previously used. We believe consumers can make better informed choice using a simpler system designed to pinpoint poor-quality nursing homes, rather than one designed to rank hundreds of facilities based on differences in quality-of-care indicators that are of questionable importance. The suggested performance model is based on five principles used in the development of the Consumers Union 2006 Nursing Home Quality Monitor.


CONCLUSIONS
We can best serve policy-makers and consumers by eschewing nursing home reporting systems that present information about all the facilities in a city, a state, or the nation on a website or in a report. We argue for greater modesty in our efforts and a focus on identifying only the potentially poorest or best homes. In the end, however, it is important to remember that information from any performance measurement website or report is no substitute for multiple visits to a home at different times of the day to personally assess quality.
Phillips
Charles D
CD
Program on Aging and Long-term Care, Department of Health Policy and Management, School of Rural Public Health, Texas A&M University System Health Science Center, College Station, Texas 77843, USA. phillipscd@srph.tamhsc.edu
Hawes
Catherine
C
Lieberman
Trudy
T
Koren
Mary Jane
MJ
D000368:Aged; D019985:Benchmarking / Q000379:methods*; D003258:Consumer Behavior; D003657:Decision Making; D005190:Family / Q000523:psychology; D019538:Health Care Surveys; D006707:Homes for the Aged / Q000191:economics / Q000592:standards*; D006801:Humans; D033181:Information Dissemination; D009735:Nursing Homes / Q000191:economics / Q000592:standards*; D010934:Planning Techniques; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires; D014481:United States