The Impact of Public Reporting on Post-Acute Care
Presented by Rachel M. Werner, M.D., Ph.D.
Dec. 4, 2008
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Abstract
Evidence supporting the use of public reporting of quality information to improve health care quality is mixed. While public reporting may improve reported quality, its effect on quality of care more broadly is uncertain.
This study tests whether public reporting in the setting of nursing homes resulted in improvement of both reported and overall quality of post-acute care. Data is from the nursing home Minimum Data Set and inpatient Medicare claims over 1999 to 2005. The research team examined changes in post-acute care quality in U.S. nursing homes in response to the initiation of public reporting on the Centers for Medicare and Medicaid Services website, Nursing Home Compare. The research team used small nursing homes that were not subject to public reporting as a contemporaneous control and also control for the changing case mix of patient in nursing homes.
Post-acute care quality was measured using three publicly reported clinical quality measures and 30-day potentially preventable rehospitalization rates, an unreported measure of quality. Reported quality of post-acute care improved after the initiation of public reporting. However, rates of potentially preventable rehospitalization did not significantly improve and, in some cases, worsened.
Rachel M. Werner, M.D., Ph.D. is an assistant professor of medicine in the Division of General Internal Medicine at the University of Pennsylvania and Core Investigator with the VA HSR&D Center for Health Equity Research and Promotion (CHERP).
Werner is a general internist and health economist whose research seeks to understand the role of quality improvement initiatives on provider behavior, the organization and financing of health care, racial disparities, and overall health care quality. Her work has recognized that public reporting of quality information may worsen racial disparities and she has been recognized through numerous awards including the Dissertation Award from AcademyHealth and the John D. Thompson Prize for Young Investigators from the Association of University Programs in Health Administration.
Last modified on Monday Jul 02, 2007