5. Public Reporting as a Quality Improvement Strategy

Author
Year
Castle
2010 81
11. Results: KQ1 (Health
Care Outcomes)
12. Results: KQ2
(Harms)
13. Results: KQ3 (Provider
Outcomes-QI & other
Behaviors)
14. Results
KQ4:(Selection
by Patients &
Payers)
N-11
15. Results: KQ5
(Impact of Public
Report
Characteristics)
16. Results: KQ6
(Impact of Contextual
Factors)
0.72 (.58-.89)**
Urinary Tract
Infection:0.85 (.61-.97)*;
.82 (.72-.95)**
Lose Too Much Weight:
0.43 (0.29-0.85)*; 0.89
(.59-.99)*
Short-Stay Residents
Delirium: 0.97 (.77-.99)*;
0.81 (.69-.95)*
Pain: 0.81(.67-.98)**;
1.10 (.91-1.32)
Pressure Sores: 0.93
(0.59-1.46); 0.81 (.63-
.99)*
none None none None Impact on quality
measure of having a
SFF NHs in the county
Coefficient (SE) for
model with all facilities.
High-risk residents with
Pressure Sores -.201
(.039) **
Low-risk residents with
Pressure Sores -.073
(.042)*
Residents with UTI -
.261 (.101)*
Short-stay residents
withe Pressure Sores -
.044 (.031)*
Any deficiency .152
(.038) **
Quality deficiency
citations .137 (.079)*
*p≤.01; **p≤.001
Remainder of quality
indicators were not
significantly different.
When only the subset of
NHs below the median
17. Summary/
Conclusion
change score was
calculated which
reduced the
magnitude but did
not eliminate the
improvement.
Improvements
were most likely in
highly competitive
markets for 8
quality measures
and in markets with
low occupancy
rates for 10 quality
measures. This
supports the idea
that report card
encourage
improvement
through marketdriven
mechanisms.
The analyses
provide partial and
relatively weak
evidence of spill
over of improved
quality in counties
with a SFF
receiving attention
for poor quality for
the NHs in the
county that had
poorer quality when
the SFF was
designated. The
increase in
deficiencies is
counter to the
spillover
hypothesis.
In both cases,
however the
number of
deficiencies and
quality of care
deficiencies cited
during inspection
18. Funder of
Research/
and Conflicts
of Interest
NIA