title: Assessing Community Quality of Health Care.
abstract: OBJECTIVE
  To determine the agreement of measures of care in different settings-hospitals, nursing homes (NHs), and home health agencies (HHAs)-and identify communities with high-quality care in all settings.
  
  
  METHODS
  Publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs).
  
  
  METHODS
  We constructed composite quality measures for hospitals, HHAs, and nursing homes. We used these measures to identify HSAs with exceptionally high- or low-quality of care across all settings, or only high hospital quality, and compared these with respect to sociodemographic and health system factors.
  
  
  RESULTS
  We identified three dimensions of hospital quality, four HHA dimensions, and two NH dimensions; these were poorly correlated across the three care settings. HSAs that ranked high on all dimensions had more general practitioners per capita, and fewer specialists per capita, than HSAs that ranked highly on only the hospital measures.
  
  
  CONCLUSIONS
  Higher quality hospital, HHA, and NH care are not correlated at the regional level; regions where all dimensions of care are high differ systematically from regions which score well on only hospital measures and from those which score well on none.
authors.affiliation: Health Research & Educational Trust, Chicago, IL.|Yale University School of Medicine, New Haven CT, Charlottesville, VA.
authors.forename: Jeph
authors.initials: J
authors.lastname: Herrin
authors.affiliation: Health Research & Educational Trust, Chicago, IL.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kenward
authors.affiliation: Health Research & Educational Trust, Chicago, IL.
authors.forename: Maulik S
authors.initials: MS
authors.lastname: Joshi
authors.affiliation: Commonwealth Fund, New York, NY.
authors.forename: Anne-Marie J
authors.initials: AM
authors.lastname: Audet
authors.affiliation: Health Research & Educational Trust, Chicago, IL.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Hines
mesh_terms: D003153:Community Health Services / Q000592:standards; D018574:Home Care Agencies / Q000458:organization & administration* / Q000592:standards; D006707:Homes for the Aged / Q000458:organization & administration* / Q000592:standards; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D009026:Mortality; D009735:Nursing Homes / Q000458:organization & administration* / Q000592:standards; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012959:Socioeconomic Factors
keywords: Quality of care; community