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Correspondence: Address correspondence to Vincent Mor, PhD, Department of Community Health, Brown University School of Medicine, Box G-A418, Providence, RI 02192. E-mail: Vincent_Mor{at}brown.edu
Purpose:This article examines various technical challenges inherent in the design, implementation, and dissemination of health care quality performance measures.Design and Methods:Using national and state-specific Minimum Data Set data from 1999, we examined sample size, measure stability, creation of ordinal ranks, and risk adjustment as applied to aggregated facility quality indicators.Results:Nursing home Quality Indicators now in use are multidimensional and quarterly estimates of incidence-based measures can be relatively unstable, suggesting the need for some averaging of measures over time. Implications:Current public reports benchmarking nursing homes' performances may require additional technical modifications to avoid compromising the fairness of comparisons.
Key Words: Quality indicators • Quality measurement • Assessment methodology • Quality of care • Benchmarking • Performance measures • Nursing homes
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