title: [Do nursing homes with higher quality ratings provide a better quality of care? : Empirical study based on administrative data].
abstract: BACKGROUND
  In 2009 a new system for the objective evaluation of nursing homes was introduced in Germany. The so-called nursing transparency agreement (Pflege-Transparenzvereinbarungen) was introduced to provide a reliable tool for an objective comparison of inpatient (PTVS) and outpatient (PTVA) care; however, the new regulations have been the subject of a broad discussion regarding reliability, efficiency and objectivity.
  
  
  OBJECTIVE
  To overcome the lack of objective health outcomes, this study used administrative data from Germany's largest health insurance fund, the Techniker Krankenkasse, in order to analyze the association between the quality ratings and objective quality measures on an individual level. This is the first study that provides empirical evidence on this topic using administrative data.
  
  
  METHODS
  The administrative dataset contained information on several individual characteristics as well as data on injuries, poisoning and other extrinsic effects on care-dependent individuals over the age of 64 years who were living in a nursing home in 2009. Based on these data an objective measure was constructed to test whether higher quality ratings of nursing homes led to a better quality of care of the respective patients using non-linear regression models.
  
  
  RESULTS
  The results of the estimated models showed no significant evidence of such a relationship, neither considering the probability nor the number of injuries, poisoning and other extrinsic effects. Significant effects were only observed for gender and specific diseases.
  
  
  CONCLUSIONS
  The results of this study support the argument that the current rating procedure for nursing homes has to be refined. Using quality indicators in combination with the administrative data could possibly contribute to such an enhancement.
authors.affiliation: Ruhr-Universität Bochum, Universitätsstr. 150, 44801, Bochum, Deutschland.
authors.forename: Adam
authors.initials: A
authors.lastname: Przylog
authors.affiliation: Ruhr-Universität Bochum, Universitätsstr. 150, 44801, Bochum, Deutschland. stroka@rwi-essen.de.|Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Essen, Deutschland. stroka@rwi-essen.de.|Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen, Hamburg, Deutschland. stroka@rwi-essen.de.
authors.forename: Magdalena A
authors.initials: MA
authors.lastname: Stroka
authors.affiliation: Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen, Hamburg, Deutschland.
authors.forename: Susanne
authors.initials: S
authors.lastname: Engel
authors.affiliation: Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen, Hamburg, Deutschland.
authors.forename: Roland
authors.initials: R
authors.lastname: Linder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019317:Evidence-Based Medicine; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000145:classification* / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards; D011041:Poisoning / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D011785:Quality Assurance, Health Care / Q000592:standards / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D012307:Risk Factors; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control
keywords: Health status; Injuries; Quality reports; Rating; Transparency