The Nursing Home Five Star Rating: How Does It Compare to Resident and Family Views of Care?

Williams, Anthony; Straker, Jane; Applebaum, Robert

doi:10.1093/geront/gnu043

Cited by 65 publications

(64 citation statements)

References 26 publications

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“…However, this comprehensiveness conflicts with comprehensibility, making it difficult for consumers to make sense of multiple quantitative measures. In 2008, CMS introduced a star rating system, giving one to five stars to nursing homes for overall quality and in each of the three subcategories of health inspections, quality of care, and staffing (Williams, Straker, and Applebaum ). Although these measures are based on expert opinion rather than consumer preferences, they nonetheless increase the comprehensibility of the information and nudge consumers toward an evidence‐based overall assessment of quality.…”

Section: Implications For Public Administratorsmentioning

confidence: 99%

When Are Nudges Desirable? Benefit Validity When Preferences Are Not Consistently Revealed

Weimer

2019

Public Administration Review

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Cost-benefit analysis, as a tool of general use in policy analysis or as a mandated analytical process in some rulemaking, provides protocols for assessing the relative efficiency of policy alternatives. However, inconsistent and apparently irrational decisions by consumers in some situations call into question the validity of inferring the values that consumers place on outcomes from their observed choices. It also opens the door for "nudges" that change the architecture of choice to promote more "rational" consumer choice. Differences between decision utility and experience utility and the willingness of consumers to pay for reductions in temptation provide conceptual bases for thinking about the efficiency of nudges. However, assessment of nudges and their role in behavioral public administration should also recognize that heterogeneous preferences can result in increases in utility for some and decreases for others. Therefore, nudges require systematic assessment like other policy instruments. Evidence for Practice• Nudges should not be viewed as panaceas; rather, they should be assessed like other policy alternatives.• When consumers make forecasting errors about the value of consumption, benefits should be assessed in terms of experience utility (the satisfaction that consumers actually realize from consumption) rather than choice utility (the satisfaction that they anticipate gaining before consumption). • Consumers who anticipate harmful temptation may obtain a benefit from the removal of the temptation from their choice set. • Heterogeneity in the prevalence of behavioral deviations from rationality, such as harmful addiction, complicates the assessment of both nudges and conventional policy interventions.

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Section: Implications For Public Administratorsmentioning

confidence: 99%

When Are Nudges Desirable? Benefit Validity When Preferences Are Not Consistently Revealed

Weimer

2019

Public Administration Review

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“…Global satisfaction has been demonstrated to be a reliable measure and is increasingly encouraged to be included in quality measurements of elderly care (e.g. Williams et al 2014).…”

Section: Measuring Quality Of Carementioning

confidence: 99%

Structure and process quality as predictors of satisfaction with elderly care

Kajonius

Kazemi

2015

Health Soc Care Community

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What is known about this topic• Quality of care can be decomposed into three distinct but related components of structure, process and outcome.• Quality of caring relationships predicts satisfaction with care. What this paper adds• In a Swedish national survey, structural variables such as budget per elderly person and care personnel certification/training showed no relationships with the elderly person's evaluation of care in terms of satisfaction, while staffing and budget per capita AbstractThe structure versus process approach to quality of care presented by Donabedian is one of the most cited ever. However, there has been a paucity of research into the empirical validity of this framework, specifically concerning the relative effects of structure and process on satisfaction with elderly care as perceived by the older persons themselves. The current research presents findings from a national survey, including a wide range of quality indicators for elderly care services, conducted in 2012 at the request of the Swedish National Board of Health and Welfare in which responses from 95,000 elderly people living in 324 municipalities and districts were obtained. The results revealed that the only structural variable which significantly predicted quality of care was staffing, measured in terms of the number of caregivers per older resident. More interestingly, process variables (e.g. respect and access to information) explained 40% and 48% of the variance in satisfaction with care, over and above the structural variables, in home care and nursing homes respectively. The findings from this large nationwide sample examining Donabedian's model suggest that quality in elderly care is primarily determined by factors pertaining to process, that is, how caregivers behave towards the older persons. This encourages a continued quality improvement in elderly care with a particular focus on process variables.Keywords: elderly care, process, quality of care, satisfaction, structure were weakly associated with satisfaction in nursing homes.• Process factors such as respect and access to information were strongly associated with satisfaction.• The integrated model on quality of care presented by Donabedian is a useful framework for predicting client satisfaction in elderly care.

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“…Lastly, five-star quality rating information was used to conduct the known group comparison in this study. Although the five-star quality rating system is a simple and informative resource for consumers and family members to understand the care quality of nursing homes, it has often been subject to criticism in terms of variations or inaccuracy in the MDS data coding for quality measures and the self-reporting system for staffing levels (Williams, Straker, & Applebaum, 2014). Thus, cautious interpretation of study findings is warranted.…”

Section: Mean (Sd)mentioning

confidence: 99%

Person-centered Climate Questionnaire-Patient in English: A psychometric evaluation study in long-term care settings

Yoon

Roberts

Grau

et al. 2015

Archives of Gerontology and Geriatrics

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The Nursing Home Five Star Rating: How Does It Compare to Resident and Family Views of Care?

Abstract: We recommend that the star system be refined to include a consumer component.

Cited by 65 publications

References 26 publications

When Are Nudges Desirable? Benefit Validity When Preferences Are Not Consistently Revealed

When Are Nudges Desirable? Benefit Validity When Preferences Are Not Consistently Revealed

Structure and process quality as predictors of satisfaction with elderly care

Person-centered Climate Questionnaire-Patient in English: A psychometric evaluation study in long-term care settings

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