5. Public Reporting as a Quality Improvement Strategy

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Evidence Report/Technology Assessment Number 208 5. Public Reporting as a Quality Improvement Strategy Closing the Quality Gap: Revisiting the State of the Science Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Contract No. 290-2007-10057-I Prepared by: Oregon Evidence-based Practice Center Portland, OR Investigators: Annette M. Totten, Ph.D. Jesse Wagner, M.A. Arpita Tiwari, M.H.S. Christen O’Haire, Ph.D. Jessica Griffin, M.S. Miranda Walker, M.A. AHRQ Publication No. 12-E011-EF July 2012
This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10057-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients. This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied. This document is in the public domain and may be used and reprinted without special permission. Citation of the source is appreciated. Persons using assistive technology may not be able to fully access information in this report. For assistance contact info@ahrq.gov. None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report. Suggested citation: Totten AM, Wagner J, Tiwari A, O’Haire C, Griffin J, Walker M. Public Reporting as a Quality Improvement Strategy. Closing the Quality Gap: Revisiting the State of the Science. Evidence Report No. 208. (Prepared by the Oregon Evidence-based Practice Center under Contract No. 290-2007-10057-I.) AHRQ Publication No. 12-E011-EF. Rockville, MD: Agency for Healthcare Research and Quality. July 2012. www.effectivehealthcare.ahrq.gov/reports/final.cfm. ii
Page 1: Evidence Report/Technology Assessme
Page 5 and 6: Acknowledgments We would like to ac
Page 7 and 8: Public Reporting as a Quality Impro
Page 9 and 10: Tables Table A. Summary Evidence Ta
Page 11 and 12: and using reports and other decisio
Page 13 and 14: • Outcomes (specified for each Ke
Page 15 and 16: Methods A Technical Expert Panel fo
Page 17 and 18: setting), and the strength of the b
Page 19 and 20: Table A. Summary evidence table: ef
Page 21 and 22: was at the time the included studie
Page 23 and 24: 6. Hibbard JH, Sofaer S. Best Pract
Page 25 and 26: access to essential information and
Page 27 and 28: providers, for purposes of this rev
Page 29 and 30: information and reduces comprehensi
Page 31 and 32: Methods Topic Nomination and Develo
Page 33 and 34: Table 1. Public reporting concepts
Page 35 and 36: • The public reporting was only a
Page 37 and 38: • Key Question 2. Harms included
Page 39 and 40: were retained, but they were not as
Page 41 and 42: Data Extraction Following full text
Page 43 and 44: Data Synthesis We separated studies
Page 45 and 46: Results Organization The results of
Page 47 and 48: Overview of Effectiveness of Public
Page 49 and 50: Access restrictions. It was unclear
Page 51 and 52: o The results of two studies sugges
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Key Question 5 What characteristics
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Long-term care • Studies that exa
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Harms (Key Question 2) • Two 52,6
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eport known as QualityCounts was pr
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Table 1. Study findings: hospital c
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o One study found that patients tre
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condition found declines for CHF (7
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developed (HCAHPS) and public repor
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Key Question 6. Context Two studies
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• Survey responses of hospitals i
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activity would influence hospital c
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Lab-Type Experiments The two articl
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Table 3. Summary of evidence: publi
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Individual Clinicians and Outpatien
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public reports influenced the contr
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New York State to trends in other S
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One study evaluated use of a Web si
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Patients. Patient reactions to publ
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Table 4. Summary of evidence: quali
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Table 4. Summary of evidence: Quali
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Health Plans Rating and reporting o
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The public reporting intervention i
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that included adjustment for severa
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Key Question 6. Context Five studie
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about patient-physician relationshi
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CAHPS results. Credibility of the r
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Long-Term Care Services Prior syste
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o Improvement in one QM (influenza
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studies that examined change and tr
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Table 6. Study findings: change in
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ehospitalizations for these patient
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improvements in the pain measure we
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Werner et al. 107 2012 included ext
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Table 7. Summary of evidence: long-
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Figure 3. Number of included quanti
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suggests the possibility that addit
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Table 8. Summary evidence table: Ef
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literature sources that we were abl
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of public reports have a wide range
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approaches to reducing bias in heal
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21. Young G. Multistakeholder regio
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60. Castle NG, Liu D, Engberg J. Th
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99. Knutson DJ, Kind EA, Fowles JB,
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141. Schneider EC, Epstein AM. Infl
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181. Scanlo DP, Chernew M, McLaughl
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222. Ketelaar NA, Faber MJ, Flottor
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Appendix A. Literature Search Datab
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CINAHL EBSCO Plus with Full Text Da
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EMBASE - Elsevier (1973-present) Da
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Public Affairs Information Service
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Full Text Review Include: Based on
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Appendix C. Included and Excluded S
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29. Castle NG, Sonon K, Antonova J.
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58. Gabel JR. When employers choose
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86. Hibbard JH, Peters E, Dixon A,
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117. Marshall M, Noble J, Davies H,
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145. Pettijohn TL, Lawrence ME. The
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174. Spranca MD, Elliott MN, Shaw R
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6. NCQA releases HEDIS 2.0 standard
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40. Pacific Business Group on Healt
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74. The effect of report cards on M
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110. MGMA addresses accuracy concer
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137. Applebaum R, Kunkel S, Wilson
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165. Barkauskas VH, Pohl JM, Benker
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193. Bindman AB, Wholey DR, Christi
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219. Bratzler DW. Development of na
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247. Caldwell B. Employers use perf
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275. Centre for R, Dissemination. P
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301. Chesanow N. Managed care 1999.
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329. Commonwealth Fund. Commission
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358. Daly JM, Jogerst GJ. Associati
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386. DeLiberty RN. Developing a pub
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412. Doty MM, Koren MJ, Sturla EL,
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439. Elliott MN, Beckett MK, Kanous
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467. Feeley TW, Fly HS, Albright H,
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494. French J. 2003 E.I. Hood Award
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522. Ginsburg PB, Kemper, N. M. Hea
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551. Graham JD. Is reporting of qua
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581. Gruber T, Rudnitsky B. Can we
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608. Hardingham L. Informed decisio
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633. Heidenreich PA, Lewis WR, LaBr
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660. Hodgson ES, Simpson L, Lannon
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689. Izakovic M. New trends in the
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718. Kakkar A, Jacobson BC. Interne
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747. Ketelaar N, Faber M, Flottorp
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772. . Importance of stratification
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800. Leonardi MJ, McGory ML, Ko CY.
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827. Livingston EH. Bariatric surge
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856. Mantone J. Massachusetts site
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882. Mazza G, Fazzi B. Five good re
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907. McKibben L, Horan T, Tokars JI
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935. Miller R, Lazar J. Public repo
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963. Morrison K. The road to JCAHO
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989. National Committee for Quality
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1017. O’Malley C. Quality measure
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1045. Peabody J. Why we love qualit
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1073. Qaseem A, Snow V, Gosfield A,
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1100. Robinowitz DL, Dudley RA. Pub
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1129. Roski J, Kim MG. Current effo
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1156. Sangl JA, Wolf LF. Role of co
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1183. Schull MJ, Guttmann A, Leaver
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1212. Shea JA, Guerra CE, Weiner J,
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1238. Simpson AG, DeGuzman PB, Barb
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1264. Sofaer S. What information do
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1292. Stewart DW, Hickson GB, Pechm
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1320. Tjia J, Field TS, Fischer SH,
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1346. Van Beek K, Duchemin S, Gersh
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1374. Weingarten JP, Jr., Fan W, Pe
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1401. Wiljer D, Bogomilsky S, Catto
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1426. Zaslavsky AM, Shaul JA, Zabor
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Appendix E. Description of Public R
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Table E1. Descriptive information a
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Table E1. Descriptive information a
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Appendix F. Method for Quality Asse
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the time periods actually prior to
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Application to Public Reporting Thi
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Table G1. Quality assessment criter
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Table G1. Quality assessment criter
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Section A Appendix H. Hospitals: Qu
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Table H1. Hospital quantitative stu
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Section B Table H2. C Hospital quan
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Author, Year (QA) Baker 2003 4 (Fai
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Author, Year (QA) Clough 2002 10 (F
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Author, Year (QA) Dranove 2003 13 (
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Author, Year (QA) Foreman 1995 16 (
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Author, Year (QA) Guru 2006 19 (Fai
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Author, Year (QA) Hibbard 2003 24 (
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Author, Year (QA) Jang 2011 28 (Fai
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Author, Year (QA) Mennemeyer 1997 3
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Author, Year (QA) Omoigui 1996 34 (
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Author, Year (QA) Pope 2009 36 (Fai
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Author, Year (QA) 9. Context: Decis
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Author, Year (QA) Vladeck 1988 42 (
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Author, Year (QA) Wuebker, 2008 45
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Table I1. Hospital qualitative stud
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Section B Table I2. Hospital qualit
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Author, Year 10. KQ3:Results 11. KQ
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Author, Year 10. KQ3:Results design
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Author, 15. Funder of Research/ Yea
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Regarding the least useful aspects,
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Section A Appendix J. Individual Pr
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Author Year (QA) Hannan 1994 21 (Go
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Author Year (QA) Mukamel 1998 33 (F
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Author Year (QA) Werner 53 2005 (Go
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Author Year (QA) Glance 2008 48 (Fa
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Author Year (QA) Hannan 1994 21 (Go
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Author Year (QA) Results: KQ1: (Hea
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Author Year (QA) Ranganathan 2009 5
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Author Year (QA) Werner 2005 53 (Go
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Author Year Barr 2008 144 1. Study
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Author Year Casalino 2007 146 1. St
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Author Year Fanjiang 2007 150 1. St
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Author Year Friedber g 2010 151 1.
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Author Year 1. Study Purpose and/or
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Author Year Longo 2003 119 1. Study
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Author Year Marshall 2006 154 Mayth
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Author Year 1. Study Purpose and/or
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Author Year Schneid er 1996 138 Con
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Author Year Schultz 2001 158 Stein
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Author Year QA Beaulieu 2002 56 Fai
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Author Year QA Chernew 2004 58 Fair
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Author Year QA Farley 2002 62 Good
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Author Year QA Hendricks 2009 66 Po
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Author Year QA 1. Study Purpose and
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Author Year QA Beaulieu 2002 56 Fai
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Author Year QA Chernew 2004 58 Fair
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Author Year QA 11. Results: KQ1: (H
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Author Year QA Farely 2002 62 Good
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Author Year QA Fowles 2000 63 Good
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Author Year QA Jung 2010 68 Good Kn
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Author Year QA 11. Results: KQ1: (H
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Author Year QA Pham 2002 73 Good 11
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Author Year QA Tae-Seale 2004 76 Fa
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Appendix M. Health Plans: Qualitati
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Author Year Farley-Short 2002 162 1
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Author Year Gabel 1998 163 1. Study
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Author Year Gibbs 1996 164 1. Study
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Author Year 1. Study Purpose 2. Geo
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Author Year Harris- Koejetin 2000 1
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Author Year Hibbard 1997 171 1. Stu
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Author Year Hibbard 2001 178 Hibbar
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Author Year Paulsbo 2007 183 Peters
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Author Year Rosenthal 2007 186 1. S
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Author Year Scanlon 2001 188 1. Stu
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Author Year Spranca 2000 190 1. Stu
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Author Year Teleki 2007 192 1. Stud
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Author Year Uhrig 2006 194 1. Study
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Section A Appendix N. Long-Term Car
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Author Year Jung 2010 85 Konetzka 2
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Author Year Werner 2009a 92 Werner
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Author Year Zinn 2010 99 1. Study P
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Author Year Castle 2007 79 Cont. 11
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Author Year Castle 2010 81 11. Resu
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Author Year Jung 2010 85 11. Result
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Author Year Mukamel 2008 86 Mukamel
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Author Year Park 2011 b 90 11. Resu
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Author Year Werner 2009 b 93 11. Re
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Author Year Werner 2010 94 Werner 2
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Author Year Zinn 2005 97 11. Result
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Author Year Zinn 2010 99 11. Result
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Appendix O. Long-Term Care: Qualita
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Author Year Castle 2005 197 1. Stud
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Author Year Gerteis 2007 198 1. Stu
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References 1. AHRQ. Methods Guide f
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36. Pope DG. Reacting to rankings:
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77. Wedig GJ, Tai-Seale M. The effe
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118. Laschober M, Maxfield M, Felt-
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157. Pettijohn TL, Lawrence ME. The
Page 645:
198. Gerteis M, Gerteis JS, Newman
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