AHRQ Grant HS21844: Related Publication Summaries

Top-down and bottom-up approaches to health care quality: the impacts of regulation and report cards

Mukamel DB, Haeder SF, and Weimer DL.
Annual Review of Public Health 2014; 35:477-97.

To analyze what is known about the impacts of these two policy approaches on quality, the authors review the extant literature on regulation and report cards. They find evidence of both functional and dysfunctional effects and identify areas in which additional research would most likely be valuable.

Personalizing Nursing Home Compare and the discharge from hospitals to nursing homes

Mukamel DB, Amin A, Weimer DL, Ladd H, Sharit J, Schwarzkopf R, Sorkin DH.
Health Services Research 2016 Dec;51(6):2076-2094.

This study tested whether use of a personalized report card, Nursing Home Compare Plus (NHCPlus), embedded in a reengineered discharge process, can lead to better outcomes than the usual discharge process from hospitals to nursing homes. It found that about 85 percent of users indicated satisfaction with NHCPlus. Compared to controls, intervention patients were more satisfied with the choice process.

When patients customize nursing home ratings, choices and rankings differ from the government's version

Mukamel DB, Amin A, Weimer DL, Sharit J, Ladd H, Sorkin DH.
Health Affairs 2016 Apr;35(4):714-9.

Report cards currently published by the Centers for Medicare & Medicaid Services (CMS) offer composite quality measures, such as the one featured on the Nursing Home Compare website. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. When comparing Nursing Home Compare Plus to Medicare's five-star ratings, we found only minimal agreement on ranking of nursing homes.

Rationale and study protocol for the Nursing Home Compare Plus (NHCPlus) randomized controlled trial: a personalized decision aid for patients transitioning from the hospital to a skilled-nursing facility

Sorkin DH, Amin A, Weimer DL, Sharit J, Ladd H, Mukamel DB.
Contemporary Clinical Trials. 2016 Mar;47:139-45.

This paper describes the design and rationale of a two-arm randomized controlled trial designed to test the effectiveness of Nursing Home Compare Plus (NHCPlus) compared to usual care only in a sample of patients being discharged from the hospital to a skilled nursing facility (N=229). Assessments were conducted within 24 hours prior to patient discharge and 30-days post discharge. A primary outcome to be examined was the use of NHCPlus.

Does mandating nursing home participation in quality reporting make a difference? Evidence from Massachusetts

Mukamel DB, Ye Z, Glance LG, Li Y.
Medical Care. 2015 Aug;53(8):713-9.

This study investigated one of the mechanisms that may detract from the effectiveness of quality report cards: voluntary versus mandatory participation of nursing homes in public quality reporting. It found that once reporting became mandatory, nonvolunteers improved more than volunteers in all but two staffing measures.

Hospital Discharge and Selecting a Skilled Nursing Facility: A Comparison of Experiences and Perspectives of Patients and Their Families

Sorkin DH, Amin A, Weimer DL, Sharit J, Ladd H, Mukamel DB.
Professional Case Management 2018 Mar/Apr;23(2):50-59.

This article seeks to examine and compare the experiences and perspectives of patients and others involved in the selection of the nursing home (predominately adult children and spouses). It found that patients were the primary decision makers about 23 percent of the time, but were often involved in the decision even when family members/involved others were primarily making decisions in the discharge process.

Resident satisfaction surveys and clinical quality of care in nursing homes: two sides of the same coin?

Mukamel D, Harrington C
Aging Health 2013 Dec; 9(6).

The authors of this article believe that quality of nursing homes is a complex, multidimensional construct. Unlike acute care hospitals, where patients are typically treated for one specific condition and stay for a short period of time, the length of stays in nursing homes varies widely. They argue that neither the individual assessment of clinical quality nor evaluation of hotel services are sufficient.