title: Making difficult decisions: the role of quality of care in choosing a nursing home.
abstract: OBJECTIVE
  We investigated how quality of care affects choosing a nursing home.
  
  
  METHODS
  We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model.
  
  
  RESULTS
  In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size.
  
  
  CONCLUSIONS
  In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers.
authors.affiliation: School of Nursing, University of Rochester, Rochester, NY 14642, USA. Irena_Pesis-Katz@URMC.Rochester.edu
authors.forename: Irena
authors.initials: I
authors.lastname: Pesis-Katz
authors.forename: Charles E
authors.initials: CE
authors.lastname: Phelps
authors.forename: Helena
authors.initials: H
authors.lastname: Temkin-Greener
authors.forename: William D
authors.initials: WD
authors.lastname: Spector
authors.forename: Peter
authors.initials: P
authors.lastname: Veazie
authors.forename: Dana B
authors.initials: DB
authors.lastname: Mukamel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002140:California; D002755:Choice Behavior; D002983:Clinical Competence / Q000592:standards*; D005382:Financing, Personal; D006272:Health Facility Environment / Q000592:standards*; D006297:Health Services Accessibility; D006801:Humans; D033181:Information Dissemination; D016015:Logistic Models; D009518:New York; D009735:Nursing Homes / Q000592:standards*; D009820:Ohio; D010067:Ownership; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000592:standards*; D011788:Quality of Life; D013781:Texas