Article

Association between Traditional Nursing Home Quality Measures and Two Sources of Nursing Home Complaints

Department of Economics, Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC.
Health Services Research (Impact Factor: 2.49). 12/2012; 48(4). DOI: 10.1111/1475-6773.12021
Source: PubMed

ABSTRACT OBJECTIVE: To test for an association between traditional nursing home quality measures and two sources of resident- and caregiver-derived nursing home complaints. DATA SOURCES: Nursing home complaints to the North Carolina Long-Term Care Ombudsman Program and state certification agency from October 2002 through September 2006 were matched with Online Survey Certification and Reporting data and Minimum Data Set Quality Indicators (MDS-QIs). STUDY DESIGN: We examine the association between the number of complaints filed against a facility and measures of inspection violations, staffing levels, and MDS-QIs. DATA EXTRACTION: One observation per facility per quarter is constructed by matching quarterly data on complaints to OSCAR data from the same or most recent prior quarter and to MDS-QIs from the same quarter. One observation per inspection is obtained by matching OSCAR data to complaint totals from both the same and the immediate prior quarter. PRINCIPAL FINDINGS: There is little relationship between MDS-QIs and complaints. Ombudsman complaints and inspection violations are generally unrelated, but there is a positive relationship between state certification agency complaints and inspection violations. CONCLUSIONS: Ombudsman and state certification agency complaint data are resident- and caregiver-derived quality measures that are distinctive from and complement traditional quality measures.

0 Followers
 · 
75 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper hypothesizes that the Medicaid reimbursement payment discourages quality nursing home care in markets with excess demand. It further shows that an increase in the prospective payment or an increase in the return on capital portion of a retrospective cost-plus payment decreases the quality provided when there is excess demand. Finally, it argues that excess demand destroys a costless signal of quality, namely, the degree of excess capacity in a home, making it more difficult for uninformed consumers to make accurate choices and resulting in markets exhibiting the characteristics of adverse selection. These hypotheses are tested using Wisconsin data.
    Journal of Health Economics 10/1985; 4(3):237-59. DOI:10.1016/0167-6296(85)90031-1 · 2.25 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Seniors' long-term care preferences resemble those of younger persons with disabilities, but the two groups are treated differently. Younger persons with disabilities pursue the goal of social integration, whereas safety and efficiency receive undue emphasis and ageist differences prevail in the way older persons are served. Among the changes needed to help older consumers get what they want are empowering older persons and their agents to make better decisions, including providing them with more structure and better consumer information; revising attitudes toward safety and protection; and developing more vigorous advocacy by and for seniors.
    Health Affairs 11/2001; 20(6):114-27. DOI:10.1377/hlthaff.20.6.114 · 4.32 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A small number of physicians experience a disproportionate share of malpractice claims and expenses. If malpractice risk is related in large measure to factors such as patient dissatisfaction with interpersonal behaviors, care and treatment, and access, it might be possible to monitor physicians' risk of being sued. To examine the association between physicians' patient complaint records and their risk management experiences. Retrospective longitudinal cohort study of 645 general and specialist physicians in a large US medical group between January 1992 and March 1998, accounting for 2546 physician-years of care. Computerized records of all unsolicited patient complaints were recorded by the medical center's patient affairs office, coded to characterize the nature of the problem and alleged offender, and compared with each physician's risk management records for the same period. Both patient complaints and risk management events were higher for surgeons than nonsurgeons. Specifically, 137 (32%) of the 426 nonsurgeons had at least 1 risk management file compared with nearly two thirds (137 [63%] of 219) of all surgeons (chi2(1)= 54.7, P<.001). Both complaint and risk management data were positively correlated with physicians' volume of clinical activity. Logistic regression revealed that risk management file openings, file openings with expenditures, and lawsuits were significantly related to total numbers of patient complaints, even when data were adjusted for clinical activity. Predictive concordance of specialty group, complaint count, clinical activity, and sex for risk management file openings was 84%; file openings with expenditures, 83%; lawsuits, 81%; and multiple lawsuits, 87%. Unsolicited patient complaints captured and recorded by a medical group are positively associated with physicians' risk management experiences.
    JAMA The Journal of the American Medical Association 07/2002; 287(22):2951-7. · 30.39 Impact Factor